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General NPI Number Information
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NPI Number | 1699627604
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Entity Type | Individual
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Provider Name | KATHRYN JORDAN RN
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Gender | Female
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 300 MAIN ST
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City | LEWISTON
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State | ME
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Zip | 04240-7041
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Country | US
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Telephone | 207-795-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 211 MAIN ST UNIT 202
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City | SABATTUS
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State | ME
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Zip | 04280-5012
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN87549
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License Number State | ME
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