Provider Demographics
NPI:1578374583
Name:HARBIN, JORDAN ANTHONY (CRNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:ANTHONY
Last Name:HARBIN
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1555 HIGHLANDS DR STE 190
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-2800
Mailing Address - Country:US
Mailing Address - Phone:717-291-8345
Mailing Address - Fax:717-568-8943
Practice Address - Street 1:1555 HIGHLANDS DR STE 190
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-2800
Practice Address - Country:US
Practice Address - Phone:717-291-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031256363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner