Individual
ANDREA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9008 BURT RD, DETROIT, MI 48228-1610
(248) 667-1997
Mailing address
8945 NORTH PARK PLACE, APT. 307, MILWAUKEE, WI 53223
(248) 667-1997
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703063848
MI
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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