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Individual

ROSETTA MAMIE JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5255 LOUGHBORO RD NW, WASHINGTON, DC 20016-2633
(202) 537-4686
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP1024215
DC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
R197037
MD

Other

Enumeration date
07/11/2022
Last updated
04/21/2023
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