Provider Demographics
NPI:1841868908
Name:CARR, JORDAN (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JORDAN
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SABLE BAY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1305
Mailing Address - Country:US
Mailing Address - Phone:940-782-5951
Mailing Address - Fax:
Practice Address - Street 1:1805 SABLE BAY LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76005-1305
Practice Address - Country:US
Practice Address - Phone:940-782-5951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily