Individual
MRS. MEGAN E. JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1353 DORCHESTER AVE, DORCHESTER, MA 02122-2932
(617) 288-3230
(617) 825-4972
Mailing address
695 TRUMAN PKWY, SUITE 203, HYDE PARK, MA 02136
(617) 361-1470
(617) 361-9060
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
258635
MA
363LP0200X
Pediatric Nurse Practitioner
258635
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC0640777I
STATE CONTROLLED LICENSE
MA
Enumeration date
10/05/2006
Last updated
03/07/2023
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