Individual
JARESSA BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 E UNION AVE, OSCEOLA, AR 72370-3235
(870) 563-1331
Mailing address
315 E UNION AVE, OSCEOLA, AR 72370-3235
(870) 563-1331
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
229765795
—
AR
Enumeration date
01/17/2019
Last updated
01/17/2019
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