Healthcare Provider Details

I. General information

NPI: 1053082933
Provider Name (Legal Business Name): JORDAN ANGELA MCSHANE AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2021
Last Update Date: 03/28/2025
Certification Date: 03/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MARSETT RD STE 3
SHELBURNE VT
05482-7150
US

IV. Provider business mailing address

10 MARSETT RD STE 3
SHELBURNE VT
05482-7150
US

V. Phone/Fax

Practice location:
  • Phone: 802-922-9545
  • Fax:
Mailing address:
  • Phone: 802-922-9545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number145.0133329
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number145.0133329
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: