Provider Demographics
NPI:1548276785
Name:JORDAN-REED, DEBORAH (NP)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:JORDAN-REED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1682
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90707-1682
Mailing Address - Country:US
Mailing Address - Phone:562-229-9452
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:10251 ARTESIA BLVD
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-6719
Practice Address - Country:US
Practice Address - Phone:562-867-8681
Practice Address - Fax:562-925-2721
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP2881363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0NP28810OtherBLUE SHIELD
CA500021848OtherRAILROAD MEDICARE
CARN296599Medicaid
CA500021848OtherRAILROAD MEDICARE
CARN296599Medicaid