IndividualActive
Jodiey Bondurant, DNP, CPNP-PC/AC, FNP
NPI 1104369917 · Pediatric Nurse Practitioner · Portland, OR
Provider details
- NPI number
- 1104369917
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- DNP, CPNP-PC/AC, FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 202101747NP-PP (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Phone: (503) 494-8122
Fax: (503) 494-1542
Approximate (ZIP-level) locationGet directions
Mailing address
3181 Sw Sam Jackson Park Rd
Portland, OR 97239-3011
Additional practice locations (2)
- 2100 Madison AveGranite City, IL 62040-4713Phone: (618) 798-3000
- 1 Childrens PlSaint Louis, MO 63110-1002Phone: (314) 454-6336
Registry dates
- Enumerated
- 2016-11-28
- Last updated
- 2023-07-19
- Certified
- 2023-04-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.