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General NPI Number Information
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NPI Number | 1699323733
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Entity Type | Individual
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Provider Name | JORDAN JOHN MADDEN DNP, CNP, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/02/2019
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 642 BRAKKE DR STE 105
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City | HUDSON
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State | WI
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Zip | 54016-7904
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Country | US
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Telephone | 715-402-4562
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Fax |
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Provider Business Mailing Address
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Address Line | 3154 GLASGOW ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-0010
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Country | US
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Telephone | 715-222-9032
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 13870-33
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 13870-33
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 9354
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 9354
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License Number State | MN
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Taxonomy #5
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2465330
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License Number State | MN
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Taxonomy #6
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 256951-30
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License Number State | WI
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