Individual
DR. JENNIFER KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PD
Contact information
Practice address
202 SOUTH LIVERMORE, HAZEN, AR 72064
(870) 255-4403
(870) 255-3772
Mailing address
PO BOX 507, HAZEN, AR 72064-0507
(870) 255-3433
(870) 255-3772
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD09944
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477688463
1477688463
AR
Enumeration date
01/08/2021
Last updated
01/08/2021
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