DEANDRE JORDAN - NPI 1790107134 - Rehabilitation Practitioner in Las Vegas, NV

The NPI number for Deandre Jordan is 1790107134. It was assigned to this individual provider in the NPPES registry on January 18, 2014.

The primary specialty registered for this NPI is Rehabilitation Practitioner with taxonomy code 225400000X.

The NPPES record for Deandre Jordan was last updated on January 18, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Deandre Jordan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEANDRE JORDAN (NPI 1790107134) is an individual rehabilitation practitioner in Las Vegas, Nevada and active in the NPI registry since January 2014.

NPI1790107134

Entity TypeIndividualMale

Primary Taxonomy225400000X

Provider Legal NameDEANDRE JORDAN

Location Address3690 N RANCHO DR, 3692 N. RANCHO DR.Las Vegas, NV 89130-3182

Mailing Address4965 Athens Bay PlN Las Vegas, NV 89031-0971 · (702) 817-3094

Sole ProprietorYes

Enumeration DateJanuary 18, 2014

✔ NPI 1790107134 is a valid, active identifier and passes the ISO check-digit test.

★ Primary SpecialtyRehabilitation PractitionerRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225400000X

Definition

A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.

3690 N RANCHO DR, Las Vegas, NV 89130

Medicaid225400000XNV

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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