Provider Demographics
NPI:1427225572
Name:JORDAN, DENAYA D
Entity Type:Individual
Prefix:MS
First Name:DENAYA
Middle Name:D
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 1:2101B CLOVERDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-7212
Mailing Address - Country:US
Mailing Address - Phone:804-458-3418
Mailing Address - Fax:
Practice Address - Street 1:2101B CLOVERDALE AVE
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-7212
Practice Address - Country:US
Practice Address - Phone:804-458-3418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA163W00000X163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse