Provider Demographics
NPI:1144757360
Name:SEMKEN, JORDAN (CRNP)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:SEMKEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MOUNT ALLEN DR STE 109
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-6171
Mailing Address - Country:US
Mailing Address - Phone:717-988-8090
Mailing Address - Fax:717-221-5408
Practice Address - Street 1:100 MOUNT ALLEN DR STE 109
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-6171
Practice Address - Country:US
Practice Address - Phone:717-988-8090
Practice Address - Fax:717-221-5408
Is Sole Proprietor?:No
Enumeration Date:2017-05-18
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN638141363L00000X
PASP017711363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103350613Medicaid