Provider Demographics
NPI:1346057692
Name:HARMON, JORDAN NICOLE
Entity type:Individual
Prefix:MRS
First Name:JORDAN
Middle Name:NICOLE
Last Name:HARMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3714 PARKSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-9453
Mailing Address - Country:US
Mailing Address - Phone:409-779-7247
Mailing Address - Fax:
Practice Address - Street 1:132 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4112
Practice Address - Country:US
Practice Address - Phone:979-849-7721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168886363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics