Individual ProviderMelanie Truesdale JordanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address115 N Sumter St Ste 400, Sumter, SC 29150-4971(803) 774-9465(803) 296-7320PECOS EnrollmentBased on the most recent information from CMS, provider Melanie Truesdale Jordan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:14 PM.Profile DetailsProvider ID1053838649Provider TypeIndividualFull NameJordan, Melanie TruesdaleCredentialFNP-CGenderFemaleSole ProprietorNoEnumeration Date8/24/2017Last Updated1/17/2019Contact InformationPractice LocationPractice Address115 N Sumter St Ste 400, Sumter, SC 29150-4971Phone(803) 774-9465FaxUnlisted FaxMailing LocationMailing AddressPO Box 743904, Atlanta, GA 30374-3904Phone(803) 296-7320Fax(803) 296-7330Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense21217South CarolinaProvider IdentifiersIDDescriptionIssuerIDNP4789DescriptionMedicaidIssuerUnlistedSouth Carolina