Individual
JORDAN LANE HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
108 N SHACKLEFORD RD, LITTLE ROCK, AR 72211-2840
(479) 269-4214
Mailing address
108 N SHACKLEFORD RD, LITTLE ROCK, AR 72211-2840
(479) 269-4214
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111111111
—
AR
Enumeration date
01/28/2019
Last updated
10/18/2022
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