Individual
JENNIE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2526 HIGHWAY 65 S STE 201, CLINTON, AR 72031-6678
(501) 745-8007
(501) 745-8220
Mailing address
2400 S 48TH ST, SPRINGDALE, AR 72762-6683
(479) 750-2020
(479) 750-4843
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A003977
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204974758
—
AR
Enumeration date
02/06/2014
Last updated
05/28/2021
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