Provider Demographics
NPI:1699292805
Name:JORDAN, LEA ELINA (CNP)
Entity type:Individual
Prefix:MRS
First Name:LEA
Middle Name:ELINA
Last Name:JORDAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:MS
Other - First Name:LEA
Other - Middle Name:ELINA
Other - Last Name:CRAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10529 LOVELAND MADEIRA RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-8963
Mailing Address - Country:US
Mailing Address - Phone:513-853-9700
Mailing Address - Fax:
Practice Address - Street 1:10529 LOVELAND MADEIRA RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-8963
Practice Address - Country:US
Practice Address - Phone:513-853-9700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.373215163W00000X
OH024576363L00000X
OHF03190398363LF0000X
OHAPRN.CNP.024576363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner