Provider Demographics
NPI:1487465134
Name:JORDAN, JASMINE
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7017 HIGHVIEW TER APT 303
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-4041
Mailing Address - Country:US
Mailing Address - Phone:202-300-0125
Mailing Address - Fax:
Practice Address - Street 1:7017 HIGHVIEW TER APT 303
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-4041
Practice Address - Country:US
Practice Address - Phone:202-300-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant