Healthcare Provider Details

I. General information

NPI: 1376450064
Provider Name (Legal Business Name): CHRISTINE JORDAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3927 N 19TH ST
OMAHA NE
68110-1764
US

IV. Provider business mailing address

3927 N 19TH ST
OMAHA NE
68110-1764
US

V. Phone/Fax

Practice location:
  • Phone: 402-906-9730
  • Fax:
Mailing address:
  • Phone: 402-906-9730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number933192221
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: