Individual
JERRE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNP
Contact information
Practice address
1901 KILLOUGH RD N, WYNNE, AR 72396
(870) 238-8707
(870) 238-8711
Mailing address
1901 KILLOUGH RD N, WYNNE, AR 72396
(870) 238-8707
(870) 238-8711
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
P01329
AR
Other
Enumeration date
06/30/2006
Last updated
02/09/2011
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