Provider Demographics
NPI:1750111456
Name:WOOLBRIGHT, JORDAN ASHLEY (APRN)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ASHLEY
Last Name:WOOLBRIGHT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32413-5215
Mailing Address - Country:US
Mailing Address - Phone:850-420-8673
Mailing Address - Fax:
Practice Address - Street 1:3141 E HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-5415
Practice Address - Country:US
Practice Address - Phone:850-785-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-06
Last Update Date:2024-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11034487363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily