CRYSTAL LYNN JORDAN


Address: 638 Oakbrook Ave, Chatham, IL 62629
Phone: 2175532815

CRYSTAL LYNN JORDAN (NPI# 1609482231) 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) 1609482231
Entity Type Individual
Full Name CRYSTAL LYNN JORDAN
Credential APRN, NP, PMHNP-BC
Practice Address 638 Oakbrook Ave
Chatham
IL 62629
Mailing Address Po Box 522
Chatham
IL 62629-0522
Practice Telephone 2175532815
Mailing Telephone 2175532815
Enumeration Date 2020-09-18
Last Update Date 2020-09-18
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
2020025752 MO Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
209021748 IL Physician Assistants & Advanced Practice Nursing Providers

Other Providers CRYSTAL JORDAN

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1003255266 Crystal Marie Jordan Nurse Practitioner 901 Washington St, Portsmouth, OH 45662-3944 2013-06-20

Office Location

Street Address 638 OAKBROOK AVE
City CHATHAM
State IL
Zip Code 62629

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1164523775 Ball Chatham Comm Unit School District 5 Local Education Agency (LEA) 201 Mulberry Street, Chatham, IL 62629 2006-09-26
1962518860 Jean Corriveau Dentist 1209 N. Main St., Chatham, IL 62629 2006-08-22
1811948201 Joyner Therapy Services Clinic/Center 217 S. Adams, Golconda, IL 62629 2006-05-12
1174905574 Sahar Yazdani Family Medicine 125 E Plummer Blvd Ste A, Chatham, IL 62629 2015-06-22
1376706234 Advance Physical Therapy & Sports Medicine of Chatham LLC Physical Therapist 1089 Jason Pl, Chatham, IL 62629 2008-07-09
1225183890 Kenneth Wayne Schmidt Family Medicine 125 E Plummer Blvd Ste A, Chatham, IL 62629 2007-01-24
1649496076 Maurice Eugene Sullivan IIi Chiropractor 1209 N Main St, #b, Chatham, IL 62629-0264 2007-04-17
1891837027 Sullivan Chiropractic of Chatham, P.C. Chiropractor 1209 N. Main St., #b, Chatham, IL 62629-0264 2007-02-13
1992293096 Katrina Toran Counselor 111 E Walnut St Unit 491, Chatham, IL 62629-0816 2018-04-25
1285806356 Ellyn Joyce Driver Early Intervention Provider Agency 30 Partridge Dr, Chatham, IL 62629-1027 2008-03-29
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City CHATHAM
Zip Code 62629

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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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