MEDICARE: JORDAN MICHELLE CALLAHAN NDTR

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	136A00000X	Registered Dietetic Technician

General Provider Information

NPI Number	:	1386599868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN MICHELLE CALLAHAN NDTR

Provider Business Mailing Address
First Line	:	940 GRASSWOOD CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-6135
Country	:	US
Telephone Number	:	817-456-4058
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 GRASSWOOD CT
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76017-6135
Country	:	US
Telephone Number	:	817-456-4058
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ JORDAN MICHELLE CALLAHAN NDTR” Practice Location

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