Provider Demographics
NPI:1457622433
Name:JORDAN, BRITTNEY (LPN)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 GLENWOOD AVE
Mailing Address - Street 2:18
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-2042
Mailing Address - Country:US
Mailing Address - Phone:513-221-2996
Mailing Address - Fax:
Practice Address - Street 1:420 GLENWOOD AVE
Practice Address - Street 2:18
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-2042
Practice Address - Country:US
Practice Address - Phone:513-221-2996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.145040164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse