Individual
NAKIA STACI JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5 GWYNNS MILL CT STE A, OWINGS MILLS, MD 21117-3529
(443) 414-1607
Mailing address
5 GWYNNS MILL CT STE A, OWINGS MILLS, MD 21117-3529
(443) 414-1607
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457940389
—
MD
Enumeration date
01/06/2021
Last updated
05/16/2023
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