Organization
JLW ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JESSICA JANE WESTFALL APN (GERIATRIC NURSE PRACTITIONER)
(870) 562-2505
Entity
Organization
Contact information
Practice address
600 LELIA, MAGNOLIA, AR 71753-4035
(870) 234-7000
Mailing address
1417 CHESTNUT, MAGNOLIA, AR 71753-2621
(870) 562-2505
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
A01537
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145671758
—
AR
01
—
5W576
BLUE CROSS BLUE SHIELD
—
Enumeration date
01/19/2009
Last updated
01/19/2009
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