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NPI Code Detail

MEDICARE: JORDAN JEFFREY GOLD CRNA

MEDICARE: JORDAN JEFFREY GOLD CRNA
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
1367500000XCertified Registered Nurse AnesthetistAC008001MD
2367500000XCertified Registered Nurse Anesthetist116154WV

General Provider Information

NPI Number : 1982395745
Entity Type Code : Individual
Provider Name (Legal Business Name) : JORDAN JEFFREY GOLD CRNA
Provider Business Mailing Address
First Line : 11116 MEDICAL CAMPUS RD
Second Line :
City : HAGERSTOWN
State : MD
Zip : 21742-6710
Country : US
Telephone Number : 301-790-8000
Fax Number :
Provider Business Practice Location Address
First Line : 501 MORRIS ST
Second Line :
City : CHARLESTON
State : WV
Zip : 25301-1326
Country : US
Telephone Number : 304-647-6006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2023
Last Update Date : 03/23/2026

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Directions to “ JORDAN JEFFREY GOLD CRNA” Practice Location

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