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NPI Code Detail

MEDICARE: MRS. DENISE ANN JORDAN LPN

MEDICARE: MRS. DENISE ANN JORDAN LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse20160917LA

General Provider Information

NPI Number : 1235092321
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DENISE ANN JORDAN LPN
Provider Business Mailing Address
First Line : 402 KELSEA DR
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4966
Country : US
Telephone Number : 337-654-2595
Fax Number : 225-439-3099
Provider Business Practice Location Address
First Line : 402 KELSEA DR
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4966
Country : US
Telephone Number : 337-654-2595
Fax Number : 225-439-3099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2025
Last Update Date : 03/23/2026

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