Basic Information
| Provider Information | |||||||||
| NPI: | 1154845931 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEESE | ||||||||
| FirstName: | JORDAN | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4617 GREENLAWN DR | ||||||||
| Address2: | |||||||||
| City: | STOW | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442245449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3308149914 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3700 PARK EAST DR STE 450 | ||||||||
| Address2: | |||||||||
| City: | BEACHWOOD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 441224318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668490692 | ||||||||
| FaxNumber: | 8889738821 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2017 | ||||||||
| LastUpdateDate: | 04/25/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | APRN.CNP.01961 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.