Provider Demographics
NPI:1750563649
Name:JORDAN, DARLENE (RN)
Entity type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85228-3514
Mailing Address - Country:US
Mailing Address - Phone:520-723-2285
Mailing Address - Fax:520-723-2258
Practice Address - Street 1:800 N 9TH ST
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85228-3514
Practice Address - Country:US
Practice Address - Phone:520-723-2285
Practice Address - Fax:520-723-2258
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN049226163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool