Provider Demographics
NPI:1013514553
Name:SMITH, JORDAN CLAIRE (MSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:CLAIRE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 FLOWOOD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9306
Mailing Address - Country:US
Mailing Address - Phone:601-420-0034
Mailing Address - Fax:
Practice Address - Street 1:2550 FLOWOOD DR STE 300
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9306
Practice Address - Country:US
Practice Address - Phone:601-420-0034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS904020363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily