Healthcare Provider Details

I. General information

NPI: 1740110873
Provider Name (Legal Business Name): JORDANA ELIZABETH MCCRACKEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9556 W BLUE SKY DR
PEORIA AZ
85383-8740
US

IV. Provider business mailing address

9556 W BLUE SKY DR
PEORIA AZ
85383-8740
US

V. Phone/Fax

Practice location:
  • Phone: 619-274-1864
  • Fax:
Mailing address:
  • Phone: 619-274-1864
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number336931
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number336931
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number336931
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number336931
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number336931
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: