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General NPI Number Information
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NPI Number | 1235092321
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Entity Type | Individual
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Provider Name | DENISE ANN JORDAN LPN, HIM, NASM FNS
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Gender | Female
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 402 KELSEA DR
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City | BROUSSARD
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State | LA
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Zip | 70518-4966
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Country | US
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Telephone | 337-654-2595
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Fax | 225-439-3099
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Provider Business Mailing Address
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Address Line | 402 KELSEA DR
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City | BROUSSARD
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State | LA
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Zip | 70518-4966
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Country | US
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Telephone | 337-654-2595
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Fax | 225-439-3099
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SC1501X
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Taxonomy Name | Community Health/Public Health Clinical Nurse Specialist
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License Number | 20160917
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 20160917
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 20160917
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 2470A2800X
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Taxonomy Name | Assistant Health Information Record Technician
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License Number | 20160917
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 20160917
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License Number State | LA
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Taxonomy #6
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Taxonomy Code | 364SI0800X
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Taxonomy Name | Informatics Clinical Nurse Specialist
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License Number | 20160917
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License Number State | LA
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Taxonomy #7
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 20160917
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License Number State | LA
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