Provider Demographics
NPI:1588549489
Name:LAMB, JORDAN (FNP-C)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:LAMB
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17223 W CARIBBEAN LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7741
Mailing Address - Country:US
Mailing Address - Phone:201-989-9992
Mailing Address - Fax:
Practice Address - Street 1:9140 W THOMAS RD STE B-106
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3378
Practice Address - Country:US
Practice Address - Phone:623-939-1375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228357207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine