Individual
MRS. KATRINA TOLLIVER JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6600 PEACHTREE DUNWOODY ROAD, BULDING 400 SUITE 125, ATLANTA, GA 30328
(866) 587-9922
Mailing address
1650 ANDERSON MILL RD APT 1107, AUSTELL, GA 30106
(770) 693-6773
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN084084
GA
Other
Enumeration date
10/12/2011
Last updated
10/12/2011
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