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Individual
TENEISHA SHAVAUGH JORDAN
Active
Individual
TENEISHA SHAVAUGH JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
84336
GA
207Q00000X
Family Medicine Physician
Primary
95139
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84336
GEORGIA MEDICAL LICENSE
GA
Enumeration date
07/08/2018
Last updated
05/07/2026
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