Individual
LISA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 W 31ST ST, JACKSONVILLE, FL 32209
(904) 888-5915
Mailing address
1515 W 31ST ST, JACKSONVILLE, FL 32209-3965
(904) 888-5915
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
05/14/2018
Last updated
05/14/2018
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