Individual
JENNIFER SUE CAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1601 NEW CASTLE RD, FORREST CITY, AR 72335-2218
(870) 261-0513
(870) 261-0535
Mailing address
318 NORCROSS DR, TYRONZA, AR 72386-3986
(870) 974-3161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R063197
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C002865
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033402250
TRICARE - SOUTH REGION
AR
05
—
187980001
—
AR
01
—
5V596
ARKANSAS BLUE CROSS BLUE SHIELD
AR
01
—
P01391010
RAILROAD MEDICARE
AR
Enumeration date
05/20/2011
Last updated
02/13/2022
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