Jordan, Elizabeth T

Jordan, Elizabeth T is an individual health care provider with primary practice located at 640 Jackson St , Saint Paul MN 55101-2502. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Jordan, Elizabeth T can be contacted via phone (651) 254-4796.

Contact Information

Primary practice address
640 Jackson St Saint Paul MN 55101-2502
Phone: (651) 254-4796
Fax: (651) 254-2741
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 44554 Minnesota

Profile Details

NPI number 1396717922
LBN Legal business name Jordan, Elizabeth T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Sep 28th, 2021 - about 3 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 1396717922 NPPES
Minnesota MEDICAID 086380700

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