Coffelt, Jordan Alyse

Coffelt, Jordan Alyse is an individual health care provider with primary practice located at 4055 N Park Loop , Memphis TN 38152-4220. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Coffelt, Jordan Alyse can be contacted via phone (901) 678-2009.

Contact Information

Primary practice address
4055 N Park Loop Memphis TN 38152-4220
Phone: (901) 678-2009
Fax: (901) 678-5497
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 426 Arkansas
Speech, Language and Hearing Service Providers / Audiologist 231H00000X A4402 Mississippi
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 1761 Tennessee

Profile Details

NPI number 1134673643
LBN Legal business name Coffelt, Jordan Alyse
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2016
Last updated Aug 19th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134673643 NPPES
Tennessee MEDICAID Q059461

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