Most Relevant Information
Provider Data
| NPI Number: | 1003653585 |
| Provider Name: | REBECCA LEEANN JORDAN |
| Entity Type: | Individual |
| Taxonomy Code: | 367500000X |
| Specialty: | Nurse Anesthetist, Certified Registered |
| License Number: | 247866 |
Most Important Dates
| Enumeration Date: | 07/11/2024 |
| Last Updated: | 07/11/2024 |
Provider Practice Location
171 ASHLEY AVE
CHARLESTON
SC
294250100
Practice Location Phone/Fax
| Phone: | 8039207547 |
| Fax: |
Provider Mailing Location
171 ASHLEY AVE
CHARLESTON
SC
294250100
Provider Mailing Phone/Fax
| Phone: | 8039207547 |
| Fax: |