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).
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 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902437023 | Crystal Nichole Jordan | Nurse Practitioner | 5662 Tranquility Oaks Dr Unit 204, Tampa, FL 33624-5846 | 2020-01-28 |
1568087724 | Crystal Jordan | Case Manager/Care Coordinator | 1216 Patrick St, Kissimmee, FL 34741-5534 | 2020-06-13 |
1003255266 | Crystal Marie Jordan | Nurse Practitioner | 901 Washington St, Portsmouth, OH 45662-3944 | 2013-06-20 |
Street Address |
638 OAKBROOK AVE |
City | CHATHAM |
State | IL |
Zip Code | 62629 |
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 |
Find all providers in zip 62629 |
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 |
---|---|---|---|---|
1790384451 | Ghea Tiping Degillo | Nurse Practitioner | 4711 Golf Rd Ste 500, Skokie, IL 60076-1208 | 2020-10-22 |
1750989620 | Rodney J Pena Jr. | Nurse Practitioner | 1362 Trotters Ln, Bourbonnais, IL 60914-4519 | 2020-10-13 |
1497369672 | Mojisola Abayemi Akinfe | Nurse Practitioner | 8572 Stone Creek Blvd, Frankfort, IL 60423-9338 | 2020-09-03 |
1508475039 | Hilary Eichie | Nurse Practitioner | 20025 Division St., Crest Hill, IL 60403 | 2020-07-30 |
1518585942 | Tabs Behavioral Health Inc | Nurse Practitioner | 13316 Vicarage Dr, Plainfield, IL 60585-5050 | 2020-07-13 |
1154946788 | Latisha Trenice Stennis | Nurse Practitioner | 8106 Carol Dr, East Saint Louis, IL 62203-1838 | 2020-06-09 |
1114549755 | Maria Andreea Bordeianu | Nurse Practitioner | 6050 N California Ave, Chicago, IL 60659-3916 | 2020-05-16 |
1104448968 | Abosede Rachel Babalola | Nurse Practitioner | 2214 Monarch St, Bourbonnais, IL 60914-2780 | 2020-05-14 |
1659909406 | Mudira Temilola Oyewole | Nurse Practitioner | 493 Leslie Ct, Des Plaines, IL 60016-8818 | 2020-03-28 |
1578190500 | Cari Ann Betts | Nurse Practitioner | 201 E Ogden Ave Ste 118, Hinsdale, IL 60521-3776 | 2020-03-27 |
Find all providers with the same taxonomy |
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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.