Individual
DANNIEL JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1200 E HOME RD, SPRINGFIELD, OH 45503-2728
(937) 522-0962
Mailing address
1200 E HOME RD, SPRINGFIELD, OH 45503-2728
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 139261-M-IV
OH
Other
Enumeration date
03/02/2016
Last updated
01/17/2018
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