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NPI Code Detail

MEDICARE: KATHERINE JORDAN CNP

MEDICARE:   KATHERINE  JORDAN  CNP
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
1207Q00000XFamily Medicine PhysicianAPRN.CNP.0029333OH
2363LP2300XPrimary Care Nurse PractitionerAPRN.CNP.0029333OH

General Provider Information

NPI Number : 1821661257
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE JORDAN CNP
Provider Business Mailing Address
First Line : 5770 KARL RD STE 400
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-3675
Country : US
Telephone Number : 614-396-6776
Fax Number : 614-396-6778
Provider Business Practice Location Address
First Line : 5770 KARL RD STE 400
Second Line :
City : COLUMBUS
State : OH
Zip : 43229-3675
Country : US
Telephone Number : 614-396-6776
Fax Number : 614-396-6778
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2021
Last Update Date : 12/06/2021

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