1952526162 NPI number — MCNEIL-JORDAN ENTERPRISES, INC

Table of content: JESSICA CIFUENTES (NPI 1225706781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952526162 NPI number — MCNEIL-JORDAN ENTERPRISES, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCNEIL-JORDAN ENTERPRISES, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952526162
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5412 HADRIAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27703-7120
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-638-5485
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5412 HADRIAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27703-7120
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-638-5485
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
MCNEIL
Authorized Official First Name:
DONNA
Authorized Official Middle Name:
Y
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
919-638-5485

Provider Taxonomy Codes

  • Taxonomy code: 136A00000X , with the licence number:  L000736 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133N00000X , with the licence number: L000736 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: L000736 . This is a "RD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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