Individual
ASHLEY JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 HEYMANN BLVD, LAFAYETTE, LA 70503-2322
(337) 504-4279
Mailing address
212 BLACK WATER RIVER DR, LAFAYETTE, LA 70508-1723
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
148699
LA
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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