Provider Demographics
NPI:1366166480
Name:TODD, JORDON DIANE RIGGS (APRN)
Entity type:Individual
Prefix:MRS
First Name:JORDON
Middle Name:DIANE RIGGS
Last Name:TODD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JORDON
Other - Middle Name:DIANE
Other - Last Name:RIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1500 1ST AVE N UNIT 3
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35203-1866
Mailing Address - Country:US
Mailing Address - Phone:205-545-5088
Mailing Address - Fax:
Practice Address - Street 1:153 N FLORIDA ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3009
Practice Address - Country:US
Practice Address - Phone:251-328-4621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11022042363LF0000X
AL1-188889363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily