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Individual

ELIZABETH A JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, RN, CRNP, PMHNP

Contact information

Practice address
8001 STATE ROAD, MOD II, SUITE 107, PHILADELPHIA, PA 19136
(215) 624-0790
(215) 524-2998
Mailing address
8001 STATE ROAD, MOD II, SUITE 107, PHILADELPHIA, PA 19136
(215) 624-0790
(215) 524-2998

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC005713
PA
163W00000X
Registered Nurse
RN662315
PA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
SP019102
PA

Other

Enumeration date
08/10/2011
Last updated
10/19/2018
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