Provider Demographics
NPI:1780257386
Name:JORDAN, JANET L (HIS)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:JORDAN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LYNN
Other - Last Name:GITERSONKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIS
Mailing Address - Street 1:3120 S RAINBOW BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-6235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3120 S RAINBOW BLVD STE 202
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-6235
Practice Address - Country:US
Practice Address - Phone:702-233-4327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVHAS-3042237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist