Provider Demographics
NPI:1538552989
Name:JORDAN-CISSORSKY, TERRI CATHERINE (NP-C)
Entity type:Individual
Prefix:
First Name:TERRI
Middle Name:CATHERINE
Last Name:JORDAN-CISSORSKY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:STE 128
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3428
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:609-789-5342
Practice Address - Street 1:217 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1703
Practice Address - Country:US
Practice Address - Phone:856-672-1115
Practice Address - Fax:856-672-9111
Is Sole Proprietor?:No
Enumeration Date:2015-03-10
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00555800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily