Individual
JENNIFER DIANE LILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
600 MEMORIAL DR, BELLA VISTA, AR 72714-1847
(479) 855-6165
Mailing address
600 MEMORIAL DR, BELLA VISTA, AR 72714-1847
(479) 855-6165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004988
AR
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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