Doctor Name: | CHRISTEN L JORDAN |
NPI Number: | 1013081553 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 01259 |
Business Practice Address: | 1 Medical Center Driive Morgantown, WV - 26506 |
Business Phone Number: | 3042934500 |
Business Fax Number: | |
Mailing Address: | Po Box 897, MORGANTOWN |
State: | WV |
Postal Code: | 265070897 |
Phone Number: | 3042937401 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 11/10/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 01259 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |