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JORDAN LYNNE SIDEBOTTOM PMHNP-BC
NPI 1053243659
Nurse Practitioner - Psychiatric/Mental Health in Salem, MA

Active since May 30, 2026
19 BERTUCCIO AVE, SALEM, MA 01970(617) 763-4464 Get Directions Write a Review

NPPES record last updated: May 30, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jordan Lynne Sidebottom Pmhnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN LYNNE SIDEBOTTOM PMHNP-BC (NPI 1053243659) is an individual psychiatric/mental health provider in Salem, Massachusetts, licensed in Massachusetts (RN2265344) and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1053243659
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameJORDAN LYNNE SIDEBOTTOMCredential: PMHNP-BC
Location Address19 BERTUCCIO AVESalem, MA 01970-2931
Mailing Address19 Bertuccio AveSalem, MA 01970-2931
Phone(617) 763-4464
Sole ProprietorNo
Enumeration DateMay 30, 2026
NPPES CertifiedMay 30, 2026
✔ NPI 1053243659 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in MA · RN2265344
19 BERTUCCIO AVE, Salem, MA 01970
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Sidebottom's NPI number?

The NPI number for Jordan Sidebottom is 1053243659. It was assigned to this individual provider in the NPPES registry on May 30, 2026.

Where is Jordan Sidebottom located?

Jordan Sidebottom practices at 19 Bertuccio Ave, Salem, MA 01970. The listed phone number is (617) 763-4464.

What is Jordan Sidebottom's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

When was this NPI record last updated?

The NPPES record for Jordan Sidebottom was last updated on May 30, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.