Provider Demographics
NPI:1295842748
Name:JORDAN, KAREN SUE (APN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:JORDAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:SUE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APN
Mailing Address - Street 1:1522 S VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-4358
Mailing Address - Country:US
Mailing Address - Phone:325-227-8842
Mailing Address - Fax:
Practice Address - Street 1:10950 US HWY 87 NORTH
Practice Address - Street 2:BOX 38
Practice Address - City:CARLSBAD
Practice Address - State:TX
Practice Address - Zip Code:76934-0038
Practice Address - Country:US
Practice Address - Phone:325-465-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX595380364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical