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Individual

MRS. MINERVA JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
REGISTERED NURSE

Contact information

Practice address
4321 ELIOT CT, MODESTO, CA 95356-8936
(209) 595-8396
Mailing address
4321 ELIOT CT, MODESTO, CA 95356-8936
(209) 595-8396

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
836048
CA
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
836048
CA

Other

Enumeration date
04/18/2019
Last updated
04/23/2019
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