DEADRA JORDAN (NPI# 1366052805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366052805 |
| Entity Type | Individual |
| Full Name | DEADRA JORDAN |
| Credential | PMHNP-BC |
| Practice Address |
5995 Summerside Dr Unit 795142 Dallas TX 75379-0095 |
| Practice Telephone | 9033436861 |
| Mailing Telephone | 9033436861 |
| Enumeration Date | 2020-08-07 |
| Last Update Date | 2020-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
1014434 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5995 SUMMERSIDE DR UNIT 795142 |
| City | DALLAS |
| State | TX |
| Zip Code | 75379-0095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902637 | Allison Kleppe | Dietitian, Registered | 6255 Oram St Apt 106, Dallas, TX 75214-3985 | 2020-11-08 |
| 1083215743 | Stephanie S Bell | Massage Therapist | 5415 Parry Ave, Dallas, TX 75223-1856 | 2020-11-07 |
| 1265033070 | Joseph Barber | Counselor | 114 Hope Dr, Dallas, GA 30157-2569 | 2020-11-06 |
| 1851992655 | Shaniyah Hawkins | Behavior Technician | 16800 Dallas Pkwy Ste 200, Dallas, TX 75248-1961 | 2020-11-06 |
| 1902407158 | Heidi Katherine Iratcabal | Religious Nonmedical Practitioner | 6484 Lontos Dr, Dallas, TX 75214-6317 | 2020-11-04 |
| 1235730409 | Cheryl Lynn Williams | Nurse Practitioner | 282 Somerset Dr, Dallas, GA 30132-9761 | 2020-11-04 |
| 1174124382 | Javarius Terrell Barber | Registered Nurse | 14362 Open Range Dr, Dallas, TX 75253-4953 | 2020-11-04 |
| 1770184970 | Jasminn Williams | Licensed Vocational Nurse | 3323 Renaissance Dr, Dallas, TX 75287-5950 | 2020-11-04 |
| 1699376723 | David James Wainwright | Nurse Practitioner | 3838 Rawlins St Apt 212, Dallas, TX 75219-4247 | 2020-11-04 |
| 1932700440 | Heather Weir | Physician Assistant | 7331 Gaston Ave Ste 180, Dallas, TX 75214-4131 | 2020-11-03 |
| Find all providers in DALLAS | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083235691 | Annemarie Osondu Odo | Nurse Practitioner | 9450 Skillman St Ste 120, Dallas, TX 75243-8235 | 2020-05-05 |
| 1740811934 | Kellie Lynn Westmoreland | Nurse Practitioner | 7777 Forest Ln Ste 833, Dallas, TX 75230-2571 | 2020-01-28 |
| 1346871696 | Ebote Ngite Nnoko | Nurse Practitioner | 108 Crescent Woode Dr, Dallas, GA 30157-5725 | 2020-01-27 |
| 1689238461 | Ican Medics and Psych Services Pllc | Nurse Practitioner | 9535 Forest Ln Ste 109, Dallas, TX 75243-5934 | 2019-04-26 |
| 1942773643 | Jo Kutty Kurian | Nurse Practitioner | 6363, Forest Park Road, 7th Floor, Suite 749, Dallas, TX 75390-9121 | 2019-01-04 |
| 1528538170 | Angel Laamber Adams | Nurse Practitioner | 7777 Forest Lane Suite C 833, Dallas, TX 75230 | 2018-11-27 |
| 1114495983 | Nwamaka Ngumezi | Nurse Practitioner | 3417 Gaston Ave Ste 815, Dallas, TX 75246-2034 | 2018-11-08 |
| 1811406150 | Justin Neal Mehan | Nurse Practitioner | 712 N Washington Ave Ste 411, Dallas, TX 75246-1626 | 2017-09-28 |
| 1114321775 | Shane Tipton | Nurse Practitioner | 6363 Forest Park Road 7th Floor Ste 749, Dallas, TX 75390-4426 | 2014-10-10 |
| 1023446457 | Natalia Albright | Nurse Practitioner | 17736 Preston Rd, Suite 101, Dallas, TX 75252-5720 | 2013-10-22 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.