Provider Demographics
NPI:1750796306
Name:ROBERTS, JORDAN L (PA-C)
Entity type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:L
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:903 FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5515
Mailing Address - Country:US
Mailing Address - Phone:215-579-6155
Mailing Address - Fax:215-860-0723
Practice Address - Street 1:903 FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-5515
Practice Address - Country:US
Practice Address - Phone:215-579-6155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2024-02-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant