Individual
JENNIFER REBECCA TETIRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-4000
Mailing address
3525 GOLF COURSE DR, ALMA, AR 72921-8609
(479) 856-4457
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A004399
AR
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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