Individual
JUDY ANN JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
7321 NW 79TH ST, KANSAS CITY, MO 64152-2150
(816) 853-9354
Mailing address
2205 W 36TH AVE, KANSAS CITY, KS 66103-2107
(913) 956-5620
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2010024055
MO
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
14-130459-062
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100098080A
—
KS
Enumeration date
03/31/2015
Last updated
03/31/2015
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