Jordan L Koebele, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP022888 Issued in PA

Practice address

420 S 5TH Ave
West Reading, PA 19611-2143

Phone

(484) 628-8000

NPI assigned

Mar 31, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1215515366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S 5TH AVE",
            "city": "WEST READING",
            "state": "PA",
            "postal_code": "196112143",
            "telephone_number": "484-628-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEBELE",
        "first_name": "JORDAN",
        "middle_name": "L",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP022888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anton J. Kleiner, M.D.
• Benjamin Matthew Kline, MD
• Alexis Bree Klopp
• Tiffany Knoll, PHARMD, MS, BCOP
• Susan Koch, C.N.M.
• William Kohman
• Greta Kolodziej, PHARMD
• Tammy Louise Kondisko, CRNA
• Laura M Koonce, CRNP
• Barbara J Koons, MSN, CRNP

• Nurse Practitioner in West Reading, PA
• Providers in West Reading, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.