Provider Demographics
NPI:1194697177
Name:JORDAN, CAITLIN (DNP APRN CPNP- AC/PC)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:JORDAN
Suffix:
Gender:F
Credentials:DNP APRN CPNP- AC/PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21127 SUNBURST AVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-4325
Mailing Address - Country:US
Mailing Address - Phone:402-699-9495
Mailing Address - Fax:
Practice Address - Street 1:14080 BOYS TOWN HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-7513
Practice Address - Country:US
Practice Address - Phone:531-355-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-19
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE116314363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics