Provider Demographics
NPI:1164102158
Name:JORDAN, DANYLA (BD,PPD)
Entity Type:Individual
Prefix:MRS
First Name:DANYLA
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:BD,PPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 E NORTHRUP DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-5228
Mailing Address - Country:US
Mailing Address - Phone:405-506-8368
Mailing Address - Fax:
Practice Address - Street 1:202 E NORTHRUP DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-5228
Practice Address - Country:US
Practice Address - Phone:405-506-8368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-24
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5603374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty