Provider Demographics
NPI:1801651963
Name:JORDAN, JENNEFER CHRISTINE (DNP, FNP-BC)
Entity type:Individual
Prefix:DR
First Name:JENNEFER
Middle Name:CHRISTINE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 N FM 620 RD APT 1703
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-4222
Mailing Address - Country:US
Mailing Address - Phone:512-963-8241
Mailing Address - Fax:
Practice Address - Street 1:8101 CAMERON RD STE 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-3816
Practice Address - Country:US
Practice Address - Phone:512-766-9979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily