Individual
MS. LAJUANA B JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
130 ENTERPRISE DR, DANVILLE, VA 24540-4070
(434) 791-2273
(434) 791-2824
Mailing address
130 ENTERPRISE DR, DANVILLE, VA 24540-4070
(434) 251-6793
(434) 791-2824
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0024167202
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0024167202
STATE LICENSE NUMBER
VA
Enumeration date
04/03/2007
Last updated
07/08/2008
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