Provider Demographics
NPI:1942910153
Name:MCCORMICK, JORDAN ELIZABETH (RN)
Entity type:Individual
Prefix:MISS
First Name:JORDAN
Middle Name:ELIZABETH
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7665 STEWART SHARON RD
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-1338
Mailing Address - Country:US
Mailing Address - Phone:412-551-3031
Mailing Address - Fax:
Practice Address - Street 1:1460 TOD AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44485-2407
Practice Address - Country:US
Practice Address - Phone:330-392-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.464436163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse