Individual
JED ALDEN ALCAIDE ISIDRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
225 E WASHINGTON AVE, JONESBORO, AR 72401-3111
(870) 207-4100
Mailing address
504 ELLIS LN, JONESBORO, AR 72401-8566
(281) 948-4370
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
216351
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
05/02/2021
Last updated
08/13/2021
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