Individual
MALINDA JEAN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 378-8129
(706) 238-8037
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 295-5331
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD002522
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
844950384C
—
GA
05
—
844950384D
—
GA
05
—
844950384E
—
GA
05
—
844950384F
—
GA
Enumeration date
12/13/2006
Last updated
05/20/2010
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