| Doctor Name: | MARY L JORDAN |
| NPI Number: | 1164545117 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,BSN |
| License Number: | 0001093822 |
| Business Practice Address: | 222 Tongass Dr Sitka, AK - 998359416 |
| Business Phone Number: | 9079668341 |
| Business Fax Number: | |
| Mailing Address: | 2 King George Cv, RUTHER GLEN |
| State: | VA |
| Postal Code: | 225465132 |
| Phone Number: | 8044481536 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WE0003X |
| License Number: | 0001093822 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Emergency |
| Taxonomy Definition: | |