Search › Louisiana › 172A00000X
Tawan Jordan
NPI 1245718550 · on the registry since 2018
Practice
- Address
- 750 E I 10 Service Rd Ste G
Slidell, LA 70461 - Phone
- (504) 228-7853
- Fax
- (504) 326-6513
- Organisation at this address
- Selfmade Transportation Service, Llc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-07-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana