Provider Demographics
NPI:1942918248
Name:BILLS, JORDAN (RN)
Entity Type:Individual
Prefix:MISS
First Name:JORDAN
Middle Name:
Last Name:BILLS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N 10TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-6192
Mailing Address - Country:US
Mailing Address - Phone:269-370-7132
Mailing Address - Fax:
Practice Address - Street 1:28740 63RD ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:MI
Practice Address - Zip Code:49013-9314
Practice Address - Country:US
Practice Address - Phone:989-205-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704339614163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse