Coretta Jordan, CNA
Individual provider Active NPI Home Health Aide · McGehee, AR
NPI 1407967508 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1407967508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- License
- 058628920598E (AR)
- Practice address
- 901 S 3Rd St
McGehee, AR 71654-2563 - Phone
- (870) 222-3806
- Fax
- (870) 222-3984
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058628920598E | AR | MD | Home Health Aide |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | 058628920598E | AR | Yes |
Addresses
Primary practice location
901 S 3Rd St
McGehee, AR 71654-2563
Mailing address
PO Box 351
McGehee, AR 71654-0351
Phone (870) 222-3806
Other providers in McGehee, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.