Individual
SHATAWN NIYKEL JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
3619 ESQUIRE DR, CANAL WINCHESTER, OH 43110-9421
(614) 900-0086
Mailing address
3619 ESQUIRE DR, CANAL WINCHESTER, OH 43110-9421
(614) 900-0086
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401451821012
OH
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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