Individual
JACEY ALICEN HAIRSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-7000
Mailing address
3824 W CAPITOL AVE, LITTLE ROCK, AR 72205-5604
(870) 370-6981
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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