Markita Jordan

Individual provider Active NPI Adult Care Home Facility · Purvis, MS

NPI 1972337533 · NPPES record last updated Aug 27, 2024

Key facts

NPI
1972337533
Entity type
Individual (NPI type 1)
Primary specialty
Adult Care Home Facility 311ZA0620X
Practice address
9 Ted LN
Purvis, MS 39475-7800
Phone
(601) 402-6953
NPI assigned
Aug 27, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X Yes

Addresses

Primary practice location

9 Ted LN
Purvis, MS 39475-7800

Mailing address

9 Ted LN
Purvis, MS 39475-7800
Phone (601) 402-6953

Other providers in Purvis, MS

All providers in Purvis, MS · Adult Care Home Facility in Mississippi

Sources for this page

Verify at the official NPI Registry.