Provider Demographics
NPI:1851139018
Name:CARDER, JENNIFER (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:CARDER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13668 HIGHWAY 270 W
Mailing Address - Street 2:
Mailing Address - City:POYEN
Mailing Address - State:AR
Mailing Address - Zip Code:72128-8003
Mailing Address - Country:US
Mailing Address - Phone:501-732-6883
Mailing Address - Fax:
Practice Address - Street 1:1 MERCY LN STE 401
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6441
Practice Address - Country:US
Practice Address - Phone:501-623-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR229837363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty