Provider Demographics
NPI:1437019627
Name:MITTET, JORDAN (FNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:MITTET
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22978 BUTTERFIELD DR NW
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:MN
Mailing Address - Zip Code:55070-7710
Mailing Address - Country:US
Mailing Address - Phone:763-230-9248
Mailing Address - Fax:
Practice Address - Street 1:22978 BUTTERFIELD DR NW
Practice Address - Street 2:
Practice Address - City:SAINT FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070-7710
Practice Address - Country:US
Practice Address - Phone:763-230-9248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13601363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner