Provider Demographics
NPI:1083763858
Name:JORDAN, CHRISTINA J (CFA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:J
Last Name:JORDAN
Suffix:
Gender:F
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:37 WHITTIER LANE
Mailing Address - City:CASCO
Mailing Address - State:ME
Mailing Address - Zip Code:04015-0343
Mailing Address - Country:US
Mailing Address - Phone:207-415-0445
Mailing Address - Fax:207-627-6024
Practice Address - Street 1:22 BRAMHALL ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-3134
Practice Address - Country:US
Practice Address - Phone:207-415-0445
Practice Address - Fax:207-627-6024
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME94035246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist