Provider Demographics
NPI:1689195711
Name:JORDAN, GERRICA E (BSW)
Entity Type:Individual
Prefix:
First Name:GERRICA
Middle Name:E
Last Name:JORDAN
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 RIDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4534
Mailing Address - Country:US
Mailing Address - Phone:225-229-6764
Mailing Address - Fax:
Practice Address - Street 1:4011 RIDGEMONT DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-4534
Practice Address - Country:US
Practice Address - Phone:225-229-6764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator