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Individual

CHARONDA KAYE JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3803 S 79TH EAST AVE # 100, TULSA, OK 74145-3218
(918) 630-5746
Mailing address
3803 S 79TH EAST AVE # 100, TULSA, OK 74145-3218
(918) 630-5746

Taxonomy

Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
37P026710818
OK

Other

Enumeration date
11/18/2019
Last updated
05/24/2021
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