Healthcare Provider Details

I. General information

NPI: 1356021919
Provider Name (Legal Business Name): ALEXANDRA JORDAN NANCE CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2023
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22301 S HAWES RD
QUEEN CREEK AZ
85142-8987
US

IV. Provider business mailing address

507 E BROWN WAY
SAN TAN VALLEY AZ
85140-7548
US

V. Phone/Fax

Practice location:
  • Phone: 480-987-5935
  • Fax:
Mailing address:
  • Phone: 480-353-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: