Individual
MS. JORDAN NICOLE KINGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1650 DIXWELL AVE, HAMDEN, CT 06514-3615
(203) 288-1700
Mailing address
23 HILLSIDE RD, WOODBURY, CT 06798-4021
(860) 689-3908
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4352
—
CT
Enumeration date
12/26/2018
Last updated
12/26/2018
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