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NPI Code Detail

MEDICARE: KATHRINE M JORDAN STNA

MEDICARE:   KATHRINE M JORDAN  STNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376K00000XNurse's Aide

General Provider Information

NPI Number : 1740557040
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRINE M JORDAN STNA
Provider Business Mailing Address
First Line : 759 GILL AVE
Second Line :
City : MARION
State : OH
Zip : 43302-6201
Country : US
Telephone Number : 740-513-8797
Fax Number :
Provider Business Practice Location Address
First Line : 759 GILL AVE
Second Line :
City : MARION
State : OH
Zip : 43302-6201
Country : US
Telephone Number : 740-513-8797
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2011
Last Update Date : 11/30/2011

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Directions to “ KATHRINE M JORDAN STNA” Practice Location

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