Jordan Kelly Mandeville
NPI #1972387504 in Springfield, Illinois
Provider Information
- NPI Number
- 1972387504
- Entity Type
- Individual
- Name
- Jordan Kelly Mandeville
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner - Psychiatric/Mental Health
- Enumeration Date
- Aug 23, 2023
- Last Updated
- Aug 23, 2023
Practice Location
- Address
- 1020 S 5TH ST
- City
- Springfield
- State
- Illinois
- ZIP Code
- 62703-2312
- Phone
- (217) 544-3143
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Psychiatric/Mental Health — Psychiatric/Mental Health |
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