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Individual
VERNON ODELL JORDAN
Active
Individual
VERNON ODELL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHW 1
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CHW1
NV
207QA0000X
Adolescent Medicine (Family Medicine) Physician
CHW1
NV
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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