Healthcare Provider Details

I. General information

NPI: 1295411288
Provider Name (Legal Business Name): JORDAN REUTER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 01/10/2025
Certification Date: 01/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8070 E MORGAN TRL STE 200
SCOTTSDALE AZ
85258-1229
US

IV. Provider business mailing address

8070 E MORGAN TRL STE 200
SCOTTSDALE AZ
85258-1229
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-4545
  • Fax: 602-714-3755
Mailing address:
  • Phone: 480-750-1200
  • Fax: 480-656-7758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number293752
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number293752
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: