Healthcare Provider Details

I. General information

NPI: 1770874356
Provider Name (Legal Business Name): MICHELLE MARGARET JORDAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2011
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 S BOULDER HWY
HENDERSON NV
89015-8533
US

IV. Provider business mailing address

1020 S BOULDER HWY
HENDERSON NV
89015-8533
US

V. Phone/Fax

Practice location:
  • Phone: 702-791-9030
  • Fax:
Mailing address:
  • Phone: 702-791-9030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1837
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: