Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Antionette Jordan

Individual provider Nurse Practitioner · NPI 1275249237

Antionette Jordan is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2022, 4 years ago. Practices with Nhs South LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2023

Practice location Address checks out

10004 Kennerly Rd Ste 374B
Saint Louis, MO 63128-2178
Phone: (314) 842-9669
Fax: (314) 842-1017
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 2022047351 (MO)

Record details

NPI number1275249237
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 24, 2023
Last updated in NPPESAugust 6, 2023
Certification dateAugust 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Nhs South Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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