MEDICARE: JULIANNA N JORDAN

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
1	3747P1801X	Personal Care Attendant		NV
2	372600000X	Adult Companion		NV

General Provider Information

NPI Number	:	1942982228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNA N JORDAN

Provider Business Mailing Address
First Line	:	480 W BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3227
Country	:	US
Telephone Number	:	832-989-4292
Fax Number	:

Provider Business Practice Location Address
First Line	:	480 W BONANZA RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-3227
Country	:	US
Telephone Number	:	832-989-4292
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2023
Last Update Date	:	08/04/2023

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Directions to “ JULIANNA N JORDAN ” Practice Location

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