Healthcare Provider Details

I. General information

NPI: 1164102158
Provider Name (Legal Business Name): DANYLA JORDAN BD,PPD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E NORTHRUP DR
OKLAHOMA CITY OK
73110-5228
US

IV. Provider business mailing address

202 E NORTHRUP DR
OKLAHOMA CITY OK
73110-5228
US

V. Phone/Fax

Practice location:
  • Phone: 405-506-8368
  • Fax:
Mailing address:
  • Phone: 405-506-8368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number5603
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: