Jordan Alyse Healy McDaniel
Internal Medicine in Jackson, MS. Individual provider (NPI-1).
NPI number1649021981
StatusActive
Last updated in NPPESJul 2, 2024
Details
- NPI
- 1649021981
- Entity type
- Individual (NPI-1)
- Name
- Jordan Alyse Healy McDaniel
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2024
- Certification date
- Jul 2, 2024
- Last updated
- Jul 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | T-5468 | MS | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | MS |
Practice location
2500 N State StJackson, MS 39216-4500
Phone 601-984-1000
Mailing address
416 Thorngate DrBrandon, MS 39042-2334
Phone 228-547-8668
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