JORDAN KELSI MAHAN (NPI# 1215225057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1215225057 |
Entity Type | Individual |
Full Name | JORDAN KELSI MAHAN |
Credential | FNP-C |
Practice Address |
4101 Wesley St Ste D Greenville TX 75401 |
Mailing Address |
4211 Joe Ramsey Blvd E Ste 100 Greenville TX 75401-7856 |
Practice Telephone | 9034085870 |
Practice Fax Number | 9034085879 |
Mailing Telephone | 9034554767 |
Enumeration Date | 2011-07-14 |
Last Update Date | 2020-10-14 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
716850 | TX | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 375097802 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760888184 | Jordan Kelsey Mahan | Speech-Language Pathologist | 5 Remington Cv, Little Rock, AR 72204-8274 | 2014-11-12 |
Street Address |
4101 WESLEY ST STE D |
City | GREENVILLE |
State | TX |
Zip Code | 75401 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528496247 | Aspen Nicole Ingle | Nurse Practitioner | 4101 Wesley St Ste D, Greenville, TX 75401 | 2013-10-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639653512 | Steven Wolanski | Occupational Therapy Assistant | Greenville Gardens Snf 3500 Park St., Greenville, TX 75401 | 2018-09-18 |
1184125460 | Heather Rae Hudson | Registered Nurse | 4911 Henry St, Greenville, TX 75401 | 2018-02-22 |
1154864742 | Kimberly Elaine Middleton | Nurse Practitioner | 4211 Joe Ramsey Blvd E Ste 105, Greenville, TX 75401 | 2016-11-30 |
1013373885 | Paul Brancheau | Podiatrist | 3900 Joe Ramsey Blvd E Bldg 5, Greenville, TX 75401 | 2016-01-11 |
1982079331 | Foresight Home Healthcare Incorporated | Home Health | 2102 Frazier Street, Greenville, TX 75401 | 2015-12-10 |
1083018451 | Johnny Sanders Jr. | Nurse's Aide | 1705 Northwest Hwy, Garland, TX 75401 | 2014-10-14 |
1942620299 | Robert Chandler Duckworth | Counselor | 4216 Wesley Street, Suite 700, Greenville, TX 75401 | 2014-04-24 |
1164843645 | Erica Rae Crawford | Psychologist | 3101 Joe Ramsey Boulevard, Suite 103a, Greenville, TX 75401 | 2013-12-30 |
1477888196 | Johnny Johnson | Physician Assistant | 4211 Joe Ramsey Blvd, Suite 100, Greenville, TX 75401 | 2009-10-14 |
1710121439 | Amanda Nicole Ramos | Social Worker | 2718 Wesley, Greenville, TX 75401 | 2009-04-24 |
Find all providers in zip 75401 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285234237 | Vb Medical Group LLC | Nurse Practitioner | 10047 Whispering Wind Dr, Greenville, IN 47124-9704 | 2020-10-29 |
1700403276 | Carolyn Lisa Fry | Nurse Practitioner | 500 Baylor Dr Apt Suite, Greenville, TX 75402-8005 | 2020-07-01 |
1033744701 | Jennifer C Carpenter | Nurse Practitioner | 2018 County Road 3318, Greenville, TX 75402-5268 | 2020-03-03 |
1659904183 | Joante Kirk | Nurse Practitioner | 1699 S Main St, Greenville, MS 38701-7364 | 2020-02-12 |
1578103859 | Michelle Earley | Nurse Practitioner | 4221 Ridgecrest Rd Ste 107, Greenville, TX 75402-6015 | 2020-01-14 |
1871138149 | Paola Andrea Mora Tobon | Nurse Practitioner | 200 Patewood Dr Ste 320, Greenville, SC 29615-3593 | 2019-11-11 |
1144863895 | Rashemia Latricia Suber | Nurse Practitioner | 814 Riviera Cir N, Greenville, MS 38701-8029 | 2019-10-25 |
1003460569 | Shaun Fitzpatrick | Nurse Practitioner | Physicians East, Pa 1850 W. Arlington Blvd., Greenville, NC 27834 | 2019-08-01 |
1487116745 | Megan Rogers Semanski | Nurse Practitioner | 890 W Faris Rd Ste 510, Greenville, SC 29605-4286 | 2019-04-04 |
1053884247 | Renee L Bridges | Nurse Practitioner | 10 Enterprise Blvd Ste 202, Greenville, SC 29615-3554 | 2019-01-10 |
Find all providers in GREENVILLE |
City | GREENVILLE |
Zip Code | 75401 |
Please comment or provide details below to improve the information on JORDAN KELSI MAHAN.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.