Provider Demographics
NPI:1902611718
Name:ELDER, JESSICA LEE (APRN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:ELDER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2387 HIGHWAY 298
Mailing Address - Street 2:
Mailing Address - City:JESSIEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:71949-9503
Mailing Address - Country:US
Mailing Address - Phone:870-340-9344
Mailing Address - Fax:
Practice Address - Street 1:903 DESOTO BLVD STE A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-6100
Practice Address - Country:US
Practice Address - Phone:501-915-0936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR232024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily