Healthcare Provider Details

I. General information

NPI: 1649429986
Provider Name (Legal Business Name): MELISSA B JORDEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W 24TH ST STE 302
ERIE PA
16502-2666
US

IV. Provider business mailing address

311 W 24TH ST STE 302
ERIE PA
16502-2666
US

V. Phone/Fax

Practice location:
  • Phone: 814-452-7246
  • Fax: 814-452-7244
Mailing address:
  • Phone: 814-452-7246
  • Fax: 814-452-7244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberOS014409
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberOS014409
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberOS014409
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: