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Individual

MRS. KATHY LYNN JORDAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM D

Contact information

Practice address
324 E ANTIETAM ST, SUITE 202, HAGERSTOWN, MD 21740-5754
(301) 766-4167
(301) 745-4164
Mailing address
13587 DONNYBROOK DR, HAGERSTOWN, MD 21742-2504

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14201
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14201
PHARMACY LICENSE NUMBER
MD
Enumeration date
01/25/2007
Last updated
07/08/2007
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