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General NPI Number Information
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NPI Number | 1366947996
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Entity Type | Individual
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Provider Name | CLAIRE ELIZABETH JORDAN MD
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Gender | Female
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 4640 JEFFERSON LN NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-2127
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Country | US
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Telephone | 505-843-6168
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Fax | 505-792-1978
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Provider Business Mailing Address
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Address Line | 6320 RIVERSIDE PLAZA LN NW STE B
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1710
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Country | US
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Telephone | 505-843-6168
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Fax | 505-792-1978
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 64028
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | MD2022-0746
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License Number State | NM
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