Provider Demographics
NPI:1932900651
Name:PEREZ, JORDAN (FNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:PEREZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 PINEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-2023
Mailing Address - Country:US
Mailing Address - Phone:978-914-3939
Mailing Address - Fax:
Practice Address - Street 1:24 ORCHARD VIEW DR STE 2
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3376
Practice Address - Country:US
Practice Address - Phone:603-782-9081
Practice Address - Fax:603-260-5581
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH113874-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily