Individual
ERIN JO DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3395
(479) 968-2345
(479) 890-2467
Mailing address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3395
(479) 968-2345
(479) 890-2497
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004708
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015019123
ANCC CERTIFICATION
—
05
—
215755758
—
AR
Enumeration date
07/19/2016
Last updated
09/15/2023
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