Provider Demographics
NPI:1649472242
Name:HOLLEN, JORDANA WERNER (MD)
Entity type:Individual
Prefix:DR
First Name:JORDANA
Middle Name:WERNER
Last Name:HOLLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5664 BEE RIDGE RD STE 203
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233-1504
Mailing Address - Country:US
Mailing Address - Phone:877-422-9355
Mailing Address - Fax:877-422-9355
Practice Address - Street 1:5664 BEE RIDGE RD STE 203
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-1504
Practice Address - Country:US
Practice Address - Phone:877-422-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2011-013182084P0800X
FLME1197852084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry