Provider Demographics
NPI:1104511708
Name:JORDAN, SHEILA ARTHELLE (LPN)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:ARTHELLE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 UNIVERSE DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25404-3491
Mailing Address - Country:US
Mailing Address - Phone:304-268-5965
Mailing Address - Fax:
Practice Address - Street 1:170 AVIATION WAY STE 102
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-6972
Practice Address - Country:US
Practice Address - Phone:304-261-4991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20123164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse