Healthcare Provider Details

I. General information

NPI: 1871892042
Provider Name (Legal Business Name): KAREN MARIE JORDAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN LACHAPELLE NP

II. Dates (important events)

Enumeration Date: 03/26/2011
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

IV. Provider business mailing address

1126 HARTFORD AVE
JOHNSTON RI
02919-7109
US

V. Phone/Fax

Practice location:
  • Phone: 401-519-1940
  • Fax: 401-351-6613
Mailing address:
  • Phone: 401-519-1940
  • Fax: 401-351-6613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number44729
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN00114
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: