Provider Demographics
NPI:1902654239
Name:MILLER JORDAN, MORGAN (CRNP)
Entity type:Individual
Prefix:MS
First Name:MORGAN
Middle Name:
Last Name:MILLER JORDAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 AL HIGHWAY 75 N
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35951-4014
Mailing Address - Country:US
Mailing Address - Phone:256-470-3841
Mailing Address - Fax:
Practice Address - Street 1:750 AL HIGHWAY 75 N
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35951-4014
Practice Address - Country:US
Practice Address - Phone:256-878-1398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-10
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-112958363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily