Individual
SHANNA D JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1967 SMITHFIELD AVE, ELLENWOOD, GA 30294-1638
(678) 485-2225
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN141952
GA
Other
Enumeration date
10/24/2023
Last updated
10/24/2023
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