| Jacquita Jordan, FNP-BC, PMHNP-BC | |
|
5115 Fontaine Blvd, Fountain, CO 80817-1061 | |
| (719) 653-7776 | |
| (719) 207-7783 |
| Full Name | Jacquita Jordan |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 11 Years |
| Location | 5115 Fontaine Blvd, Fountain, Colorado |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730558834 | NPI | - | NPPES |
| 42820065 | Medicaid | CO | |
| 9000108092 | Medicaid | CO |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Fountain Valley Health Care Llc | 6608252663 | 4 |
| Entity Name | Poudre Valley Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225356868 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
| Entity Name | Fountain Valley Health Care Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275272924 PECOS PAC ID: 6608252663 Enrollment ID: O20220929000653 |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquita Jordan, FNP-BC, PMHNP-BC 10265 Rolling Ridge Rd, Colorado Springs, CO 80925-9509 Ph: (719) 653-7776 | Jacquita Jordan, FNP-BC, PMHNP-BC 5115 Fontaine Blvd, Fountain, CO 80817-1061 Ph: (719) 653-7776 |
Mrs. Malory Kay Splawn, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 350 Lyckman Pl, Fountain, CO 80817 Phone: 719-632-5700 | |
Andrea Verlare, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273 Fax: 719-380-0228 | |
Jennifer Keys, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6908 Mesa Ridge Pkwy, Fountain, CO 80817 Phone: 719-471-2273 Fax: 719-380-0228 | |
Mrs. Brooke Danielle Pratt, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6161 Timber Rail Point, Suite 100, Fountain, CO 80817 Phone: 719-365-0110 Fax: 719-365-0111 | |
Arely Dominguez Gonzalez, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 350 Lyckman Pl, Fountain, CO 80817 Phone: 719-632-5700 Fax: 719-322-0776 | |
Ann-marie Bourque-koch, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7955 Fountain Mesa Rd, Fountain, CO 80817 Phone: 719-776-3737 Fax: 719-776-3740 | |
Dr. Adam Lee Randall, DNP, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7415 Araia Dr, Fountain, CO 80817 Phone: 863-224-2903 |