Provider Demographics
NPI:1013334465
Name:MCCRAY, JORDAN ANN
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:ANN
Last Name:MCCRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 W DOUGLAS ST
Mailing Address - Street 2:PO BOX 246
Mailing Address - City:ONEILL
Mailing Address - State:NE
Mailing Address - Zip Code:68763-1719
Mailing Address - Country:US
Mailing Address - Phone:402-336-2800
Mailing Address - Fax:402-336-2849
Practice Address - Street 1:405 W DOUGLAS ST
Practice Address - Street 2:
Practice Address - City:ONEILL
Practice Address - State:NE
Practice Address - Zip Code:68763-1719
Practice Address - Country:US
Practice Address - Phone:402-336-2800
Practice Address - Fax:402-336-2849
Is Sole Proprietor?:No
Enumeration Date:2014-03-24
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator