Individual
JENNA M PRAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
701 SOUTH ST STE 100, MOUNTAIN HOME, AR 72653-4452
(801) 668-6897
Mailing address
701 SOUTH ST STE 100, MOUNTAIN HOME, AR 72653-4452
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230964
AR
Other
Enumeration date
12/11/2024
Last updated
12/11/2024
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