Individual
ALFRED JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2501
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2501
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA1000006672
AZ
Other
Enumeration date
04/11/2011
Last updated
04/11/2011
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