Individual
JARED GRANT WINTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
225 E JACKSON AVE, JONESBORO, AR 72401-3119
(870) 972-4100
Mailing address
PO BOX 8099, JONESBORO, AR 72403-8099
(870) 932-4211
(870) 931-9141
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R80233
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C002955
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193230001
—
AR
Enumeration date
05/09/2012
Last updated
10/24/2013
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