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General NPI Number Information
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NPI Number | 1699627646
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Entity Type | Individual
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Provider Name | EMILY RACHELLE JORDAN
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Gender | Female
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Dates
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Enumeration Date | 02/12/2026
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Last Update Date | 03/10/2026
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Provider Practice Location Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2501
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Country | US
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Telephone | 217-383-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 247 S RIVER RD
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City | COVINGTON
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State | IN
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Zip | 47932-8059
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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 | 163WX0002X
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Taxonomy Name | High-Risk Obstetric Registered Nurse
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License Number | 41497055
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 209034935
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License Number State | IL
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