Provider Demographics
NPI:1114760436
Name:JORDON-SUMPTER, ALISHIA (LPN)
Entity type:Individual
Prefix:
First Name:ALISHIA
Middle Name:
Last Name:JORDON-SUMPTER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 LASHER RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-5104
Mailing Address - Country:US
Mailing Address - Phone:215-970-3103
Mailing Address - Fax:
Practice Address - Street 1:4026 LASHER RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-5104
Practice Address - Country:US
Practice Address - Phone:215-970-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9610147163W00000X
PAPN297503164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty
No163W00000XNursing Service ProvidersRegistered Nurse