Provider Demographics
NPI:1568205508
Name:JORDEN, KENYA (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KENYA
Middle Name:
Last Name:JORDEN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5530 HOLLEY LN
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-3314
Mailing Address - Country:US
Mailing Address - Phone:504-284-0550
Mailing Address - Fax:
Practice Address - Street 1:1525 RIVER OAKS RD W
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70123-2162
Practice Address - Country:US
Practice Address - Phone:504-284-0550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA158517163WP0808X
LA237785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health