MEDICARE: GLORIA JORDAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant	J635282777706	MI

General Provider Information

NPI Number	:	1013868124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA JORDAN

Provider Business Mailing Address
First Line	:	19366 BARLOW ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2165
Country	:	US
Telephone Number	:	313-500-0021
Fax Number	:

Provider Business Practice Location Address
First Line	:	19366 BARLOW ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48205-2165
Country	:	US
Telephone Number	:	313-500-0021
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/09/2026

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Directions to “ GLORIA JORDAN ” Practice Location

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