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JERRE DOUGLAS RNP

>> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1275562688

Individual Registrant:
 JERRE  DOUGLAS RNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1901 KILLOUGH RD N  WYNNE, AR 72396 US
Tel: 870-238-8707  Fax: 870-238-8711

Contact information for business:
1901 KILLOUGH RD N  WYNNE, AR 72396 US
Tel: 870-238-8707  Fax: 870-238-8711

Registration Information:
NPI: 1275562688
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363L00000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
ARP01329

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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