Provider Demographics
NPI:1861682825
Name:JOURDEN, DEBRA L
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:L
Last Name:JOURDEN
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 1:8320 CINNAMON TEAL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3349
Mailing Address - Country:US
Mailing Address - Phone:405-721-1172
Mailing Address - Fax:
Practice Address - Street 1:8320 CINNAMON TEAL DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-3349
Practice Address - Country:US
Practice Address - Phone:405-721-1172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies