Individual
JEROMY EUGENE TEAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4 HOSPITAL DR, MORRILTON, AR 72110-4510
(501) 977-2300
Mailing address
1630 JASMINE LN, CONWAY, AR 72034-8446
(501) 908-5249
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CTP-000137
AR
Other
Enumeration date
05/28/2010
Last updated
05/28/2010
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