Healthcare Provider Details

I. General information

NPI: 1427993781
Provider Name (Legal Business Name): JORDAN CHRISTOPHER BELTRAN NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 FLATBUSH AVENUE EXT
BROOKLYN NY
11201-2903
US

IV. Provider business mailing address

2815 OAKLAND DR
KINSTON NC
28504-1131
US

V. Phone/Fax

Practice location:
  • Phone: 718-215-1818
  • Fax:
Mailing address:
  • Phone: 336-988-9231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number312968
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: