Jordan, Elaine R

Jordan, Elaine R is an individual health care provider with primary practice located at 3999 Fort Campbell Blvd , Hopkinsville KY 42240-4929. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Jordan, Elaine R can be contacted via phone (270) 886-2205.

Contact Information

Primary practice address
3999 Fort Campbell Blvd Hopkinsville KY 42240-4929
Phone: (270) 886-2205
Fax: (270) 886-0392
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 1713 Kentucky

Profile Details

NPI number 1942625793
LBN Legal business name Jordan, Elaine R
Credentials LPCA
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2014
Last updated Mar 3rd, 2014 - about 10 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 1942625793 NPPES
Kentucky MEDICAID 30602015

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