Individual
JENNIFER PHASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Mailing address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L053166
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
AR
Enumeration date
02/23/2023
Last updated
02/23/2023
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