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

Tiffany Rae Jordan, NP

Individual provider Family Nurse Practitioner · NPI 1316693047

Tiffany Rae Jordan, NP is a Nurse Practitioner in Kennesaw, Georgia. Qualified in 2021, 5 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
5
Licensed in
GA
In the registry since
2022
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone: (770) 421-8005
Fax: (770) 424-5662
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN240185 (GA)

Record details

NPI number1316693047
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedFebruary 22, 2022
Last updated in NPPESFebruary 22, 2022
Certification dateFebruary 22, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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