Moore, Jordan Russell

Moore, Jordan Russell is an individual health care provider with primary practice located at 206 S Mulberry St Ste A , Mount Vernon OH 43050-3331. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Moore, Jordan Russell can be contacted via phone (740) 326-9988.

Contact Information

Primary practice address
206 S Mulberry St Ste A Mount Vernon OH 43050-3331
Phone: (740) 326-9988
Fax: (740) 326-1175
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN.CNP.025092 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN.CNP.025092 Ohio

Profile Details

NPI number 1821651571
LBN Legal business name Moore, Jordan Russell
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2019
Last updated Jul 25th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1821651571 NPPES
Ohio Other APRN.CNP.025092 STATE LICENSE NUMBER

Popular Providers