Provider Demographics
NPI:1972599447
Name:JORDAENS, FRANK C JR (NP)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:C
Last Name:JORDAENS
Suffix:JR
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 W POYTHRESS ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-2532
Mailing Address - Country:US
Mailing Address - Phone:804-458-3429
Mailing Address - Fax:804-541-7113
Practice Address - Street 1:815 W POYTHRESS ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-2532
Practice Address - Country:US
Practice Address - Phone:804-520-1110
Practice Address - Fax:804-526-3105
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024102283363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010297532Medicaid
VA500000570Medicare PIN
VA010297532Medicaid
VAVV13509844Medicare PIN
VAP00091357Medicare PIN