MRS. MIRANDA LYALLS JORDAN (NPI# 1457824393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457824393 |
| Entity Type | Individual |
| Full Name | MRS. MIRANDA LYALLS JORDAN |
| Credential | FNP |
| Practice Address |
310 Hospital Ave Jefferson NC 28640 |
| Mailing Address |
266 Witherspoon Heights Rd Jefferson NC 28640-9043 |
| Practice Telephone | 3368466322 |
| Mailing Telephone | 3369779724 |
| Enumeration Date | 2019-01-03 |
| Last Update Date | 2019-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
5011326 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1619907334 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902399496 | Miranda Jordan | Technician/Technologist | 32100 Telegraph Rd, Bingham Farms, MI 48025-2452 | 2018-06-11 |
| 1447742515 | Miranda Jordan | Behavior Technician | 8200 Georgia St, Merrillville, IN 46410-6227 | 2018-06-04 |
| 1518480219 | Miranda L Jordan | Counselor | 295 Hospital St, Moulton, AL 35650-1210 | 2017-07-25 |
| 1609209378 | Miranda Lohrenz Jordan | Pharmacist | 1481 W 10th St # 119, Indianapolis, IN 46202-2803 | 2013-08-16 |
| Street Address |
310 HOSPITAL AVE |
| City | JEFFERSON |
| State | NC |
| Zip Code | 28640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194324756 | Jessica Raegan Mcneil | Nurse Practitioner | 310 Hospital Ave, Jefferson, NC 28640-2864 | 2020-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851917710 | Lux Psychiatry, Pllc | Psychiatry & Neurology | 101 Colvard Street, Jefferson, NC 28640 | 2020-06-17 |
| 1902466543 | Emily Claire Wilson | Physical Therapist | 419 East Main Street Unit 4, Jefferson, NC 28640 | 2019-06-17 |
| 1659859247 | Molly Reynolds | Physical Therapist | 419 E. Main St. Unit 4, Jefferson, NC 28640 | 2018-08-06 |
| 1548644040 | Amanda Stroud | Dentist | 225 Court Street, Jefferson, NC 28640 | 2015-07-14 |
| 1710388772 | Schuster Physical Therapy Inc. | Clinic/Center | 419 E. Main St., Jefferson, NC 28640 | 2014-09-09 |
| 1437589199 | Rebecca Scoggin Clark | Nurse Practitioner | 413 Mcconnell Street, Jefferson, NC 28640 | 2013-11-16 |
| 1093029498 | Robin Arlene Edwards | Nurse Practitioner | 151 Medical Park Dr., Jefferson, NC 28640 | 2010-07-28 |
| 1659516979 | Patricia Ann Franklin | Physical Therapist | 125 Colvard Farm Rd, Unit 7, Jefferson, NC 28640 | 2008-12-16 |
| 1730363342 | Ashe County Public Schools | Local Education Agency (LEA) | 320 South Street, Jefferson, NC 28640 | 2007-12-19 |
| 1225217383 | Elizabeth Jean Wynja | Physician Assistant | 310 Hospital Avenue, Jefferson, NC 28640 | 2007-10-25 |
| Find all providers in zip 28640 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019739 | Thomas R. Dupree Jr. | Nurse Practitioner | 321 Brooks, Jefferson, TX 75657-4443 | 2020-06-26 |
| 1750908620 | Tammy K Dupree | Nurse Practitioner | 321 Brooks # 321, Jefferson, TX 75657-4443 | 2020-06-26 |
| 1699235929 | Emmley L Cole | Nurse Practitioner | 277 E W Broadway Blvd, Jefferson, TN 37760 | 2019-03-22 |
| 1942779772 | Rebekah Hawkins | Nurse Practitioner | 57 Slate Ave, Jefferson, GA 30549-8220 | 2018-11-22 |
| 1013431394 | Susan Eva Harrison Martinez | Nurse Practitioner | 1514 Jefferson Hwy Fl 1, Jefferson, LA 70121-2429 | 2017-07-28 |
| 1154843373 | Stephanie Ann Mason | Nurse Practitioner | 127 Park Dr, Jefferson, GA 30549-1269 | 2017-07-10 |
| 1548706443 | Christopher Touzeau | Nurse Practitioner | 4118 Camden Dr, Jefferson, MD 21755-7302 | 2017-01-16 |
| 1033660584 | Jenia Harris | Nurse Practitioner | 530 Brown St, Jefferson, LA 70121-2602 | 2016-10-19 |
| 1194111658 | Gretchen Geist | Nurse Practitioner | N4810 State Road 89, Jefferson, WI 53549-9629 | 2015-04-11 |
| 1801295480 | Karen Wetherington | Nurse Practitioner | 341 General Jackson Dr, Jefferson, GA 30549-2909 | 2014-08-19 |
| Find all providers in JEFFERSON | ||||
Please comment or provide details below to improve the information on MRS. MIRANDA LYALLS JORDAN.
| 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.