| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JORDAN LEAH STROUD | 1457934069 | 2021-05-01 |
Jordan Leah Stroud is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1457934069. Registration indicates Jordan Leah Stroud is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Jordan Leah Stroud |
| Practice Office Address | 325 N STATE OF FRANKLIN RD JOHNSON CITY, TN US |
| Practice Office Telephone | 4234397320 |
| Practice Office Fax | 4234397343 |
| Mailing Address | 325 N STATE OF FRANKLIN RD JOHNSON CITY, TN 376046056 US |
| Business Telephone | 4234397320 |
| Business Fax | 4234397343 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |