Provider Information for 1841517315
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
TRICIA JORDAN
Sex: Female
NPI: 1841517315
Last Updated: 2010-04-23
Certification Date:
Certification Date:
Details
Name | Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
NPI | 1841517315 | ||||||||
Enumeration Date | 2010-04-23 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 120 S MADISON AVE STE 120 ELK CITY, OK 73644-5741 United States Phone: 580-821-2318 | Fax:580-225-1130 | ||||||||
Primary Practice Address | 120 S MADISON AVE STE 120 ELK CITY, OK 73644-5741 United States Phone: 580-821-2318 | Fax:580-225-1130 | ||||||||
Secondary Practice Address(es) | |||||||||
Health Information Exchange |
| ||||||||
Other Identifiers |
| ||||||||
Taxonomy |
|