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General NPI Number Information
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NPI Number | 1902611718
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Entity Type | Individual
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Provider Name | JESSICA LEE ELDER APRN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 903 DESOTO BLVD STE A
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City | HOT SPRINGS VILLAGE
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State | AR
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Zip | 71909-6100
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Country | US
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Telephone | 501-915-0936
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Fax |
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Provider Business Mailing Address
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Address Line | 2387 HIGHWAY 298
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City | JESSIEVILLE
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State | AR
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Zip | 71949-9503
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Country | US
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Telephone | 870-340-9344
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 232024
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License Number State | AR
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