MEDICARE: CATHLEEN M JORDAN

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
1	364SA2200X	Adult Health Clinical Nurse Specialist	26NO11400900	NJ
2	364S00000X	Clinical Nurse Specialist	26NJ00344500	NJ

General Provider Information

NPI Number	:	1760762645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHLEEN M JORDAN

Provider Business Mailing Address
First Line	:	2208 EVERGREEN DR
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-2843
Country	:	US
Telephone Number	:	609-338-8222
Fax Number	:

Provider Business Practice Location Address
First Line	:	134 S RIVER DR
Second Line	:
City	:	WILLIAMSTOWN
State	:	NJ
Zip	:	08094-2542
Country	:	US
Telephone Number	:	609-338-8222
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2011
Last Update Date	:	04/11/2025

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Directions to “ CATHLEEN M JORDAN ” Practice Location

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