JACQUELINE JORDAN (NPI# 1215422514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215422514 |
| Entity Type | Individual |
| Full Name | JACQUELINE JORDAN |
| Credential | PA-C |
| Practice Address |
809 Main St East Hartford CT 06108-3142 |
| Mailing Address |
49 Sherman Ln Hamden CT 06514-1326 |
| Practice Telephone | 8605281359 |
| Mailing Telephone | 2013125863 |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2018-06-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
23.004134 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 94 Connecticut Blvd, East Hartford, CT 061083013 | 8605281359 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225412497 | Jacqueline Jordan | Case Manager/Care Coordinator | 5521 Sw 10th Ave, Topeka, KS 66604-2101 | 2015-07-16 |
| 1114292331 | Jacqueline Jordan | Registered Nurse | 65 Southfield St, Kingston, NY 12401-1913 | 2012-03-21 |
| 1912224064 | Jacqueline D Jordan | Social Worker | 6815 W. Capitol Avenue, Milwaukee, WI 53216 | 2010-04-29 |
| 1477671618 | Jacqueline Ann Jordan | Psychiatry & Neurology | 949 Saint Andrews Cir, Geneva, IL 60134-2995 | 2007-03-26 |
| 1801497193 | Jacqueline Jordan | Clinic/Center | 2100 Comer Ave, Columbus, GA 31904-8725 | 2020-11-04 |
| 1205477346 | Jacqueline Jordan | Home Health Aide | 2639 Naylor Rd Se Apt 102, Washington, DC 20020-7249 | 2019-09-30 |
| 1700349115 | Jacqueline Lovon Jordan | Counselor | 172 Spring St Sw, Concord, NC 28025-5035 | 2019-04-11 |
| 1801253257 | Jacqueline Jordan | Counselor | 217 Brevard Ct Ste A, Alexandria, LA 71303-3997 | 2016-01-15 |
| 1023373644 | Jacqueline B Jordan | Speech-Language Pathologist | 358 Mclaws Cir, Suite 1, Williamsburg, VA 23185-6344 | 2012-07-10 |
| 1134447105 | Jacqueline Marie Jordan | Social Worker | 1117 N Jackson St, Bloomington, IN 47404-3385 | 2010-05-14 |
| Street Address |
809 MAIN ST |
| City | EAST HARTFORD |
| State | CT |
| Zip Code | 06108-3142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649880444 | Fabiana Aretusa Silva | Social Worker | 809 Main St, East Hartford, CT 06108-3117 | 2020-08-06 |
| 1285283747 | Jacqueline Andria Dietrich | Nurse Practitioner | 809 Main St, East Hartford, CT 06108-3117 | 2019-09-08 |
| 1477106722 | Amelia Flater | Physician Assistant | 809 Main St, East Hartford, CT 06108-3117 | 2019-07-16 |
| 1932558442 | Thomas Nicholas Shusterman | Social Worker | 809 Main St, East Hartford, CT 06108-3142 | 2016-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003437435 | Decent Homecare Services LLC | Homemaker | 527 Burnside Avenue, Suite 1, East Hartford, CT 06108 | 2020-04-27 |
| 1164055810 | First Choice Health Center Inc | Durable Medical Equipment & Medical Supplies | 110 Connecticut Blbd, East Hartford, CT 06108 | 2020-02-20 |
| 1457848731 | Heavenly Care LLC | Home Health | 35 Greene Terrace, East Hartford, CT 06108 | 2018-04-22 |
| 1750894275 | Thamara Vanessa Jonathas | Nurse Practitioner | 477 Connecticut Blvd Ste 119, East Hartford, CT 06108 | 2017-11-06 |
| 1851802474 | Empathic Care Counseling LLC | Counselor | 357 East Center Street, Manchester, CT 06108 | 2017-10-23 |
| 1235654427 | Kacey Megquier | Specialist/Technologist | 132 Arbutus Street, East Hartford, CT 06108 | 2017-08-08 |
| 1225559826 | First Choice Health Centers, Inc. | Clinic/Center | 809 Main Street, East Hartford, CT 06108 | 2017-07-05 |
| 1205361599 | Freda Osei-parker | Pharmacist | 16a Saint Regis Street, East Hartford, CT 06108 | 2017-04-25 |
| 1831648740 | Marcia Loving Care Home Care Agency | Home Health | 23 Bidwell Street, East Hartford, CT 06108 | 2016-10-04 |
| 1770932642 | First Choice Health Centers, Inc. | Clinic/Center | 92 Connecticut Boulevard, East Hartford, CT 06108 | 2016-06-10 |
| Find all providers in zip 06108 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508161969 | Misti Talati | Physician Assistant | 478 Burnside Ave, 2nd Floor, East Hartford, CT 06108-2406 | 2011-01-17 |
| 1649428269 | Rahat S Hussain | Physician Assistant | 677 Silver Ln, East Hartford, CT 06118-1257 | 2008-09-08 |
| 1437326923 | Monica Massabni | Physician Assistant | 94 Connecticut Blvd, East Hartford, CT 06108-3013 | 2008-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163671 | Kirsten Alexandra Drobiak | Physician Assistant | 37 Jennifer Ln, Griswold, CT 06351-3500 | 2020-10-28 |
| 1255955019 | Amanda Uscilla | Physician Assistant | 20 Hilltop Rd, Bethany, CT 06524-3514 | 2020-06-07 |
| 1689208571 | Sage Ann Miele | Physician Assistant | 149 Water St Apt 32, Norwalk, CT 06854-3758 | 2020-02-28 |
| 1790319655 | Erin Kelly Flynn | Physician Assistant | 464 Congress Ave # Suie260, New Haven, CT 06519-1361 | 2020-02-28 |
| 1659919702 | Jeniece Kayla Wert | Physician Assistant | 100 Church Street South, Suite A230 Room A235, New Haven, CT 06519-1703 | 2019-12-18 |
| 1811547508 | Gabriela M Vargas | Physician Assistant | 24 Hospital Ave # Tower7, Danbury, CT 06810-6099 | 2019-09-16 |
| 1275192049 | Molly J Mable | Physician Assistant | 282 Washington St Fl 1, Hartford, CT 06106-3322 | 2019-06-06 |
| 1003377631 | Stephan Anton Bayer | Physician Assistant | 205 Elm St Apt 5, West Haven, CT 06516-4659 | 2019-03-27 |
| 1578024105 | Vance P Baughman | Physician Assistant | 325 Lafayette St Unit 1003, Bridgeport, CT 06604-5472 | 2019-03-27 |
| 1588121354 | Jason Michael Nies | Physician Assistant | 20 York St # 218, New Haven, CT 06510-3220 | 2019-02-27 |
| Find all providers with the same taxonomy | ||||
| City | EAST HARTFORD |
| Zip Code | 06108 |
Please comment or provide details below to improve the information on JACQUELINE JORDAN.
| 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.