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Individual

EARLINE H. JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
2725 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(662) 449-1808
(662) 449-1811
Mailing address
2725 HIGHWAY 51 S, HERNANDO, MS 38632-2634
(662) 449-1808
(662) 449-1811

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262449011
MS
Enumeration date
07/14/2017
Last updated
07/14/2017
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