Provider Demographics
NPI:1881182178
Name:HORRELL, JORDAN TAYLOR (CPCO)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:TAYLOR
Last Name:HORRELL
Suffix:
Gender:F
Credentials:CPCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:961 NW HAYES AVE APT 24
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4581
Mailing Address - Country:US
Mailing Address - Phone:458-233-9994
Mailing Address - Fax:541-833-6657
Practice Address - Street 1:961 NW HAYES AVE APT 24
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4581
Practice Address - Country:US
Practice Address - Phone:458-233-9994
Practice Address - Fax:541-833-6657
Is Sole Proprietor?:No
Enumeration Date:2018-04-23
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246YC3302XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health InformationCoding Specialist, Physician Office Based