Healthcare Provider Details

I. General information

NPI: 1073533139
Provider Name (Legal Business Name): ARLYS JORDA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ARLYS JORDA CRNA

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N 7TH ST
BISMARCK ND
58501-4439
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 701-323-6000
  • Fax: 701-323-6000
Mailing address:
  • Phone: 605-328-6585
  • Fax: 605-328-6512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR21055
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: