MEDICARE: MS. JORDAN ALLEN

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	376J00000X	Homemaker

General Provider Information

NPI Number	:	1508679515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JORDAN ALLEN

Provider Business Mailing Address
First Line	:	5919 N 52ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-1301
Country	:	US
Telephone Number	:	402-452-0257
Fax Number	:

Provider Business Practice Location Address
First Line	:	5919 N 52ND ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68104-1301
Country	:	US
Telephone Number	:	402-452-0257
Fax Number	:

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

Provider Enumeration Date	:	01/31/2025
Last Update Date	:	01/31/2025

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Directions to “ MS. JORDAN ALLEN ” Practice Location

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