Provider Demographics
NPI:1477217156
Name:JORDON, BOBBI (LPN)
Entity type:Individual
Prefix:MS
First Name:BOBBI
Middle Name:
Last Name:JORDON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 EASY ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3128
Mailing Address - Country:US
Mailing Address - Phone:724-912-7511
Mailing Address - Fax:
Practice Address - Street 1:3591 PITTSBURGH RD
Practice Address - Street 2:
Practice Address - City:PERRYOPOLIS
Practice Address - State:PA
Practice Address - Zip Code:15473-1307
Practice Address - Country:US
Practice Address - Phone:724-736-8390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN096451L164W00000X
PARN799379163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No164W00000XNursing Service ProvidersLicensed Practical Nurse