Provider Demographics
NPI:1184672925
Name:JORDAN, LINDA S (NP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:JORDAN
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:200 MILL RD
Mailing Address - Street 2:STE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:1030 PRESIDENT AVE
Practice Address - Street 2:SUITE 1001
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5923
Practice Address - Country:US
Practice Address - Phone:508-730-3000
Practice Address - Fax:508-730-3071
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2016-02-17
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Provider Licenses
StateLicense IDTaxonomies
MA95119363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110016466AMedicaid
MA110016466AMedicaid
RI408642OtherBLUE CHIP
RI0000025599OtherRHODE ISLAND BLUE SHIELD
MA0357502Medicaid
MANP2513OtherMASS BLUE SHIELD
MA0021912OtherNEIGHBORHOOD HEALTH PLAN