Provider Demographics
NPI:1023685716
Name:ESPERSEN, JORDAN LAYNE (PMHNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:LAYNE
Last Name:ESPERSEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:JORDAN
Other - Middle Name:
Other - Last Name:ESPERSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:381 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:HARLEYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19438-1673
Mailing Address - Country:US
Mailing Address - Phone:256-698-4788
Mailing Address - Fax:
Practice Address - Street 1:5501 FORTUNES RIDGE DR STE P
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6102
Practice Address - Country:US
Practice Address - Phone:919-391-7202
Practice Address - Fax:919-391-7203
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2020040466363LP0808X
NC5014893363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health