Provider Demographics
NPI:1316401938
Name:ALBERTS, JORDAN NICOLE (COTA/L)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:NICOLE
Last Name:ALBERTS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:KAMPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:213 8TH ST
Mailing Address - Street 2:
Mailing Address - City:APLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:50604-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:213 8TH ST
Practice Address - Street 2:
Practice Address - City:APLINGTON
Practice Address - State:IA
Practice Address - Zip Code:50604-1000
Practice Address - Country:US
Practice Address - Phone:319-215-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant