Healthcare Provider Details

I. General information

NPI: 1902710890
Provider Name (Legal Business Name): ERIN JORDAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 RIVER WIND DR
MARION AR
72364-2605
US

IV. Provider business mailing address

326 RIVER WIND DR
MARION AR
72364-2605
US

V. Phone/Fax

Practice location:
  • Phone: 870-559-1829
  • Fax:
Mailing address:
  • Phone: 870-559-1829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number125016
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: