Individual
JENELLE WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Mailing address
10100 KANIS RD, LITTLE ROCK, AR 72205-6202
(501) 255-6000
(501) 255-6400
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
124001
AR
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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