Provider Demographics
NPI:1609268762
Name:MEEKER, JORDAN CARMEN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:CARMEN
Last Name:MEEKER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:MEEKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:1815 1ST AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-5417
Mailing Address - Country:US
Mailing Address - Phone:193-630-4743
Mailing Address - Fax:501-978-1822
Practice Address - Street 1:1815 1ST AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5417
Practice Address - Country:US
Practice Address - Phone:193-630-4743
Practice Address - Fax:501-978-1822
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101911207N00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207N00000XAllopathic & Osteopathic PhysiciansDermatology