Farrah Nicole Tucker Jordan

Primary specialty

PharmacistTaxonomy code 183500000X

License

PD16896 Issued in AR

Practice address

600 Highway 71 N
Mena, AR 71953-4392

Phone

(479) 394-3897

NPI assigned

May 30, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Farrah Nicole Tucker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1053151613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 WELCH ST",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722063350",
            "telephone_number": "501-773-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 HIGHWAY 71 N",
            "city": "MENA",
            "state": "AR",
            "postal_code": "719534392",
            "telephone_number": "479-394-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER JORDAN",
        "first_name": "FARRAH",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD16896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FARRAH",
            "last_name": "TUCKER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Kennedy Counseling LLC
• Chau Tran, PHARMD
• Rhonda Tranter, RN
• Barbara Travis, APRN
• TTJ, Inc
• Jeffery Lane Ulmer, P.A.-C.
• David Wayne Vanwinkle, D.D.S.
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walk in Center

• Pharmacist in Mena, AR
• Providers in Mena, AR by specialty
• Pharmacist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.