Provider Demographics
NPI:1720781321
Name:JORDAN, VALARIE (DNP, PMHNP-BC, RN)
Entity Type:Individual
Prefix:DR
First Name:VALARIE
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7701 LINDBERGH BLVD APT 217
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19153-2107
Mailing Address - Country:US
Mailing Address - Phone:215-519-2490
Mailing Address - Fax:
Practice Address - Street 1:827 N FRANKLIN ST # 978-1300
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19123-2004
Practice Address - Country:US
Practice Address - Phone:215-978-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP027324363LP0808X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health