Provider Demographics
NPI:1932910494
Name:JORDAN, JANAE
Entity type:Individual
Prefix:MISS
First Name:JANAE
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 EDGEWOOD ST NE APT 719
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3321
Mailing Address - Country:US
Mailing Address - Phone:202-459-1700
Mailing Address - Fax:
Practice Address - Street 1:3298 FORT LINCOLN DR NE APT 725
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-4328
Practice Address - Country:US
Practice Address - Phone:202-280-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant