Individual
MISS TACARRA SIMONE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 HOSPITAL DR, NORTHPORT, AL 35476-3360
(205) 333-4970
Mailing address
225 30TH AVE E, TUSCALOOSA, AL 35404-2664
(205) 523-2911
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-143328
AL
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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