MIA JORDAN (NPI# 1225327562) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225327562 |
| Entity Type | Individual |
| Full Name | MIA JORDAN |
| Credential | PMHNP-BC |
| Practice Address |
100 Madison Ave # 28 Morristown NJ 07960-6136 |
| Mailing Address |
110 Maple St Springfield MA 01105-1864 |
| Practice Telephone | 9739714634 |
| Practice Fax Number | 9732907614 |
| Mailing Telephone | (413) 732-7419 |
| Mailing Fax Number | 4137811059 |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
26NJ00736500 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 110 Maple St, Springfield, MA 011051864 | 4137327419 | 4137811059 |
| Street Address |
100 MADISON AVE # 28 |
| City | MORRISTOWN |
| State | NJ |
| Zip Code | 07960-6136 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587050 | Deborah Ann Straka-demarco | Physical Therapist | 131 Madison Avenue, 3rd Floor, Morristown, NJ 07960 | 2020-10-27 |
| 1962009381 | Savannah Haririe | Family Medicine | 9 N Dorado Dr, Morristown, NJ 07960 | 2020-10-08 |
| 1063034718 | Cerebral Palsy of North Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1050 Mount Kemble Avenue, Harding, NJ 07960 | 2020-05-15 |
| 1154801967 | Danielle M Rediker | Physical Therapist | 25 Lindsley Drive Morristown, Nj 07960, 207, Morristown, NJ 07960 | 2018-08-21 |
| 1982105631 | Erin Scott | Counselor | 15 Elliott Street, Morristown, NJ 07960 | 2018-02-27 |
| 1992152029 | Alfre Inc. | Clinic/Center | 56 Mt Kemble Ave, Morrsitown, NJ 07960 | 2016-05-18 |
| 1285081588 | Pamela Marel | Social Worker | 3 First Street, Apt#2, Morristown, NJ 07960 | 2016-05-17 |
| 1346696671 | Community Options Enterprises, Inc | Day Training, Developmentally Disabled Services | 150 -152 Speedwell Avenue, Morristown, NJ 07960 | 2016-05-05 |
| 1841654274 | Matthew Olesiak | Student in an Organized Health Care Education/Training Program | 100 Madison Avenue, Morristown, Nj 07960, Morristown, NJ 07960 | 2016-04-12 |
| 1912372392 | Universal Rehabilitation & Fitness Center Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 41 Tiger Lily Ln, Morristown, NJ 07960 | 2015-12-10 |
| Find all providers in zip 07960 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154591055 | Kristal Lay Hurst | Nurse Practitioner | 1079 E Morris Blvd, Morristown, TN 37813 | 2008-03-06 |
| 1730398504 | Sandra Mclaughlin Johanson | Nurse Practitioner | 10 Oak Park Dr, Morristown, NJ 07960-4615 | 2007-05-21 |
| 1215949300 | Hela E Russell | Nurse Practitioner | 1329 W Andrew Johnson Hwy, Morristown, TN 37814-3728 | 2006-08-13 |
| 1245749902 | Suzanne Beth Taylor | Nurse Practitioner | Morristown Medical Center, 100 Madison Avenue, Morristown, NJ 07960 | 2017-09-26 |
| 1043556707 | Janine M Tremblay Phd Apnc | Nurse Practitioner | 150 Madison Ave, Morristown, NJ 07960-6099 | 2012-12-27 |
| 1396040234 | Marah Michele Kabaservice | Nurse Practitioner | 815 W 5th North St, Morristown, TN 37814 | 2011-01-25 |
| 1790906436 | Michael R Robbins | Nurse Practitioner | 1329 W Andrew Johnson Hwy, Morristown, TN 37814-3728 | 2007-05-01 |
| 1770616708 | Jody Annette Fletcher | Nurse Practitioner | 815 W 5th North St, Morristown, TN 37814 | 2007-03-13 |
| 1417064064 | Rita Dessau | Nurse Practitioner | 100 Madison Ave, Morristown, NJ 07960-6136 | 2006-08-23 |
| 1710959705 | Margaret King | Nurse Practitioner | 100 Madison Ave, Morristown, NJ 07960-6136 | 2006-02-03 |
| Find all providers in MORRISTOWN | ||||
| City | MORRISTOWN |
| Zip Code | 07960 |
Please comment or provide details below to improve the information on MIA 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.