Individual
DONEYL NICKCOLE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
7989 IRIS LN, ORE CITY, TX 75683-6201
(903) 720-1605
Mailing address
7989 IRIS LN, ORE CITY, TX 75683-6201
(903) 720-1605
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
328794
TX
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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