Dodge, Erin Jo

Dodge, Erin Jo is an individual health care provider with primary practice located at 101 Skyline Dr , Russellville AR 72801-3395. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Dodge, Erin Jo can be contacted via phone (479) 968-2345.

Contact Information

Primary practice address
101 Skyline Dr Russellville AR 72801-3395
Phone: (479) 968-2345
Fax: (479) 890-2467
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A004708 Arkansas

Profile Details

NPI number 1245683895
LBN Legal business name Dodge, Erin Jo
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2016
Last updated Sep 15th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245683895 NPPES
Other 2015019123 ANCC CERTIFICATION
MEDICAID 215755758 ANCC CERTIFICATION

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