Jodie Rae Archer, FNP
Nurse Practitioner, Pediatrics in Lubbock, TX. Individual provider (NPI-1).
NPI number1942536347
StatusActive
Last updated in NPPESDec 3, 2021
Details
- NPI
- 1942536347
- Entity type
- Individual (NPI-1)
- Name
- Jodie Rae Archer
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 20, 2009
- Certification date
- Dec 3, 2021
- Last updated
- Dec 3, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0200X | Nurse Practitioner, Pediatrics | AP118590 | TX | Yes |
| 363LF0000X | Nurse Practitioner, Family | AP118590 | TX |
Practice location
4102 24th St Ste 504Lubbock, TX 79410-1805
Phone 806-743-7700 · Fax 806-743-7703
Mailing address
Po Box 5865Lubbock, TX 79408-5865
Phone 806-743-2898 · Fax 806-743-2787
Other practice locations
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 32 Pediatric Nurse Practitioner providers in Lubbock · All 7,272 providers in Lubbock
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