Dakota Jordan, PA-C
Physician Assistant in Colorado Springs, CO. Individual provider (NPI-1).
NPI number1164092185
StatusActive
Last updated in NPPESJul 6, 2021
Details
- NPI
- 1164092185
- Entity type
- Individual (NPI-1)
- Name
- Dakota Jordan
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 30, 2021
- Certification date
- Jul 6, 2021
- Last updated
- Jul 6, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA.0006813 | CO | Yes |
| 208800000X | Urology | PA.0006813 | CO |
Practice location
175 S Union Blvd Ste 315Colorado Springs, CO 80910-3126
Phone 719-365-3700
Mailing address
2695 Rocky Mountain Ave Ste 150Loveland, CO 80538-9071
Phone 970-624-4034
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