Individual
MELISSA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3228 E GRANADA RD, PHOENIX, AZ 85008-3830
(623) 312-7824
Mailing address
3228 E GRANADA RD, PHOENIX, AZ 85008-3830
(623) 312-7824
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
279187
AZ
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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