Individual
JACQUELINE JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
809 MAIN ST, EAST HARTFORD, CT 06108-3142
(860) 528-1359
Mailing address
49 SHERMAN LN, HAMDEN, CT 06514-1326
(201) 312-5863
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
23.004134
CT
Other
Enumeration date
06/28/2018
Last updated
06/28/2018
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