Provider Demographics
NPI:1669259768
Name:CUMMINGS, JORDAN (CNM, WHNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9530 MILLTRAIL DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-1422
Mailing Address - Country:US
Mailing Address - Phone:214-562-4477
Mailing Address - Fax:
Practice Address - Street 1:1801 INWOOD RD FL 6
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7202
Practice Address - Country:US
Practice Address - Phone:214-645-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135799363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health