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Contact Information

STEPHANIE JORDAN
9500 CAMPCREEK RD
LUCASVILLE, OH45648
 Phone: 740-981-4844
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Contractor

171W00000X
Indicates primary specialty

NPI Profile & details for STEPHANIE JORDAN · (Female)

NPI # 1720495260
Status Active
Credentials
Entity Individual
Enumeration date 07/16/2014
Last updated 07/20/2014 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 2527902
  • OH Medicaid 2527902
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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