Healthcare Provider Details

I. General information

NPI: 1821993049
Provider Name (Legal Business Name): LINDA JORDAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 NEWCASTLE RD
HALFMOON NY
12065-6123
US

IV. Provider business mailing address

1 NEWCASTLE RD
HALFMOON NY
12065-6123
US

V. Phone/Fax

Practice location:
  • Phone: 518-371-4300
  • Fax:
Mailing address:
  • Phone: 518-371-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF400229-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: