Individual
JANNA LYN JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5 MEDICAL PARK DR, SUITE 102A, BENTON, AR 72015-3729
(501) 315-1222
(501) 315-1222
Mailing address
5 MEDICAL PARK DR, SUITE 102A, BENTON, AR 72015-3729
(501) 315-1222
(501) 315-1241
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E5062
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
162043001
—
AR
01
—
T2006-171
STATE LICENSE
AR
Enumeration date
10/18/2006
Last updated
12/15/2010
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