Individual
TAMMARA ANN JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,CCC-SLP
Contact information
Practice address
102 MEDICAL PARK, HATTIESBURG, MS 39401
(601) 261-5159
(601) 545-1740
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3310
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2203
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0800517
CIGNA
MS
05
—
1772892
—
MS
01
—
3504919
UNITED HEALTHCARE
MS
01
—
6061226
HEALTHSPRINGS
MS
01
—
731632210
MS CHIP
MS
01
—
7345349
AETNA
MS
01
—
7346349
AETNA
MS
Enumeration date
01/18/2007
Last updated
08/24/2020
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