Jordan, Carolyn

Jordan, Carolyn is an individual health care provider with primary practice located at 236 Highland Ave , Somerville MA 02143-1495. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Jordan, Carolyn can be contacted via phone (617) 591-6300.

Contact Information

Primary practice address
236 Highland Ave Somerville MA 02143-1495
Phone: (617) 591-6300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X RN256168 Massachusetts

Profile Details

NPI number 1649344094
LBN Legal business name Jordan, Carolyn
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2006
Last updated Feb 21st, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649344094 NPPES
Massachusetts MEDICAID 110076848

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