Provider Demographics
NPI:1730075953
Name:JARDON, DENISE
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:JARDON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 360TH AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:IA
Mailing Address - Zip Code:51649-6038
Mailing Address - Country:US
Mailing Address - Phone:712-625-3871
Mailing Address - Fax:
Practice Address - Street 1:1170 360TH AVE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:IA
Practice Address - Zip Code:51649-6038
Practice Address - Country:US
Practice Address - Phone:712-625-3871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker