Provider Demographics
NPI:1679192942
Name:SCHNEBLY, JORDAN SCOTT (MSN CRNA)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:SCOTT
Last Name:SCHNEBLY
Suffix:
Gender:M
Credentials:MSN CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:23 OAK BROOK DR
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-7808
Mailing Address - Country:US
Mailing Address - Phone:501-941-0790
Mailing Address - Fax:870-972-3021
Practice Address - Street 1:9601 BAPTIST HEALTH DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6321
Practice Address - Country:US
Practice Address - Phone:501-202-2093
Practice Address - Fax:501-202-6316
Is Sole Proprietor?:No
Enumeration Date:2020-04-15
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR125819367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered