MRS. SUSAN E. JORDAN


Address: 707 N Logan Avenue, Danville Polyclinic, Ltd., Danville, IL 61832-4360
Phone: 2174774720

MRS. SUSAN E. JORDAN (NPI# 1003913799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003913799
Entity Type Individual
Full Name MRS. SUSAN E. JORDAN
Other Name MISS SUSAN E KURTZ
Credential APN
Practice Address 707 N Logan Avenue
Danville Polyclinic, Ltd.
Danville
IL 61832-4360
Practice Telephone 2174774720
Practice Fax Number 2174774758
Mailing Telephone 2174774720
Mailing Fax Number 2174774758
Enumeration Date 2006-09-17
Last Update Date 2015-01-05
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
209004797 IL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL 209004797 05

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Office Location

Street Address 707 N LOGAN AVENUE
DANVILLE POLYCLINIC, LTD.
City DANVILLE
State IL
Zip Code 61832-4360

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

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Competitor

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City DANVILLE
Zip Code 61832

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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