MEDICARE: RACHEL ELIZABETH KORDON APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ15273200	NJ
2	363LW0102X	Women's Health Nurse Practitioner	26NR20122000	NJ

General Provider Information

NPI Number	:	1992594360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ELIZABETH KORDON APN

Provider Business Mailing Address
First Line	:	123 FRANKLIN CORNER RD STE 214
Second Line	:
City	:	LAWRENCEVILLE
State	:	NJ
Zip	:	08648-2526
Country	:	US
Telephone Number	:	609-537-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 FRANKLIN CORNER RD STE 214
Second Line	:
City	:	LAWRENCE
State	:	NJ
Zip	:	08648-2526
Country	:	US
Telephone Number	:	609-537-7200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/02/2025
Last Update Date	:	06/10/2025

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