JORDAN LEA ANDERSON (NPI# 1720500747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720500747 |
| Entity Type | Individual |
| Full Name | JORDAN LEA ANDERSON |
| Other Name | JORDAN LEA BLAKEN |
| Credential | PA-C |
| Practice Address |
1836 South Ave La Crosse WI 54601-5429 |
| Practice Telephone | 6087827300 |
| Mailing Telephone | 6087827300 |
| Enumeration Date | 2017-07-11 |
| Last Update Date | 2019-04-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 4056-23 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
4056 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841823515 | Jordan Marquis Anderson | Counselor | 694 Hwy #4 E, Holly Springs, MS 38635 | 2020-02-20 |
| 1336709377 | Jordan Christine Anderson | Pharmacist | 183 Center St, Bangor, ME 04401-4839 | 2019-06-20 |
| 1013344498 | Jordan Anderson | Dentist | 5807 Nw 166th St, Ridgefield, WA 98642-8553 | 2013-10-01 |
| 1811261092 | Jordan Allen Anderson | Specialist/Technologist | 7 Happ Road, New Trier Township High School, Northfield, IL 60093 | 2012-03-06 |
| 1083220446 | Jordan Anderson | Behavior Technician | 800 S Broadway Ste 310, Walnut Creek, CA 94596-5218 | 2020-09-21 |
| 1952928624 | Jordan Anderson | Physical Therapist | 2131 S Business Dr, Sheboygan, WI 53081-5656 | 2020-06-29 |
| 1770117210 | Jordan Anderson | Pharmacist | 9527 S 27th St, Franklin, WI 53132-9533 | 2020-02-24 |
| 1568095230 | Jordan Paige Anderson | Registered Nurse | 1959 Ne Pacific St, Seattle, WA 98195-0001 | 2020-02-20 |
| 1558928861 | Jordan Lynn Anderson | Case Manager/Care Coordinator | 4919 Canal St Ste 203, New Orleans, LA 70119-5878 | 2019-05-22 |
| 1003386269 | Jordan Anderson | Occupational Therapist | 1234 Napier Ave, Saint Joseph, MI 49085-2112 | 2018-11-30 |
| Street Address |
1836 SOUTH AVE |
| City | LA CROSSE |
| State | WI |
| Zip Code | 54601-5429 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952304834 | Susan G Maclellan-tobert | Pediatrics | 1836 South Ave, La Crosse, WI 54601-5429 | 2005-05-24 |
| 1861099590 | Ellen Compton | Dietitian, Registered | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-10-06 |
| 1699382630 | Jedd Sebion | Pharmacist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-09-24 |
| 1104436351 | Taryn Jean Simon | Speech-Language Pathologist | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-08-03 |
| 1497376438 | Eva Igler | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-30 |
| 1568083608 | Benjamin Haase Thompson | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-29 |
| 1316568736 | Eric Bobel | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-27 |
| 1134749708 | Kristin Danielle Heslep | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1982224598 | Rebecca Stanek | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-23 |
| 1609496595 | Marie Gilberte Cineus | Student in an Organized Health Care Education/Training Program | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891324265 | Meagan Mcrae | Student in an Organized Health Care Education/Training Program | 1725 State St., 4051 Health Science Center, La Crosse, WI 54601 | 2020-04-07 |
| 1255969671 | Erin Dingman | Student in an Organized Health Care Education/Training Program | 1751 State Street, 4051 Health Science Center, La Crosse, WI 54601 | 2020-03-31 |
| 1619505047 | Nicole Kay Lynch | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State St, La Crosse, WI 54601 | 2020-03-31 |
| 1174151757 | Jenna Sells | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1740818301 | Katie Irene Tahtinen | Student in an Organized Health Care Education/Training Program | Uwl- 4051 Health Science Center, 1725 State St., La Crosse, WI 54601 | 2020-03-30 |
| 1932737517 | Margaret May Grimm | Student in an Organized Health Care Education/Training Program | Univesity of Wisconsin-la Crosse, 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1831727312 | Matthew Timothy Axler | Student in an Organized Health Care Education/Training Program | 4051 Health Science Center, 1725 State Street, La Crosse, WI 54601 | 2020-03-30 |
| 1093340473 | Denise Stinson | Technician | 1311 Badger St, Apt 505, La Crosse, WI 54601 | 2020-03-06 |
| 1922632397 | Ibrahim Ahsan | Pharmacist | 1105 Wi-16, La Crosse, WI 54601 | 2020-02-25 |
| 1750913356 | Liza R Collins | Massage Therapist | 1415 State Wi 16, La Crosse, WI 54601 | 2020-02-11 |
| Find all providers in zip 54601 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548264989 | Jeffrey W Mueller | Physician Assistant | 1526 Rose St, La Crosse, WI 54603-2245 | 2005-06-13 |
| 1790313625 | Brian J Sesolak | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-03-27 |
| 1609403856 | Stephanie Erin Doyle | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2020-03-26 |
| 1609439983 | Hannah Mickelson | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2019-04-22 |
| 1164985867 | Kimberly Rose Mrozek | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2019-04-09 |
| 1043777584 | Cullen Richard Vos | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2019-02-20 |
| 1346706660 | Landon Bresina | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2019-02-11 |
| 1184194706 | Aubrey Wesely | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2018-11-26 |
| 1033687488 | Brittany Zinnel | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2018-11-04 |
| 1659851376 | Jennifer Ann Fassbinder | Physician Assistant | 1836 South Ave, La Crosse, WI 54601-5429 | 2018-08-21 |
| Find all providers in LA CROSSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.