Provider Demographics
NPI:1730668740
Name:DENN, JORDANA K (CD)
Entity Type:Individual
Prefix:
First Name:JORDANA
Middle Name:K
Last Name:DENN
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2314 RIVER PARK CIR APT 2134
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-4828
Mailing Address - Country:US
Mailing Address - Phone:908-500-8844
Mailing Address - Fax:
Practice Address - Street 1:2314 RIVER PARK CIR APT 2134
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-4828
Practice Address - Country:US
Practice Address - Phone:908-500-8844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL174H00000X, 374J00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program