Provider Demographics
NPI:1609268762
Name:MEEKER, JORDAN CARMEN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:CARMEN
Last Name:MEEKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:
Other - Last Name:MEEKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:4261 STOCKTON DRIVE SUITE LL100
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2962
Mailing Address - Country:US
Mailing Address - Phone:501-975-7456
Mailing Address - Fax:501-978-1822
Practice Address - Street 1:9601 BAPTIST HEALTH DR STE 860
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6375
Practice Address - Country:US
Practice Address - Phone:501-975-7455
Practice Address - Fax:501-975-3631
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-593363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical