Individual
MIA JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
100 MADISON AVE # 28, MORRISTOWN, NJ 07960-6136
(973) 971-4634
(973) 290-7614
Mailing address
110 MAPLE ST, SPRINGFIELD, MA 01105-1864
(413) 732-7419
(413) 781-1059
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00736500
NJ
Other
Enumeration date
04/06/2011
Last updated
07/21/2022
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