Provider Demographics
NPI:1497511091
Name:VENTURINA, JORDEN MORY (RN, BSN)
Entity Type:Individual
Prefix:
First Name:JORDEN
Middle Name:MORY
Last Name:VENTURINA
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 WENTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-1278
Mailing Address - Country:US
Mailing Address - Phone:760-691-9678
Mailing Address - Fax:
Practice Address - Street 1:1508 WENTWOOD DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-1278
Practice Address - Country:US
Practice Address - Phone:176-069-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1127162163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation