Provider Demographics
NPI:1295411288
Name:REUTER, JORDAN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:REUTER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8070 E MORGAN TRL STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1229
Mailing Address - Country:US
Mailing Address - Phone:480-750-1200
Mailing Address - Fax:480-656-7758
Practice Address - Street 1:8070 E MORGAN TRL STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1229
Practice Address - Country:US
Practice Address - Phone:480-882-4545
Practice Address - Fax:602-714-3755
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-23
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2937522084P0802X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ142776Medicaid