Healthcare Provider Details

I. General information

NPI: 1730668740
Provider Name (Legal Business Name): JORDANA K DENN CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2018
Last Update Date: 08/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 RIVER PARK CIR APT 2134
ORLANDO FL
32817-4828
US

IV. Provider business mailing address

2314 RIVER PARK CIR APT 2134
ORLANDO FL
32817-4828
US

V. Phone/Fax

Practice location:
  • Phone: 908-500-8844
  • Fax:
Mailing address:
  • Phone: 908-500-8844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: