Individual
MRS. JOAN M JAGGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10 E LOVERS LN, FAYETTEVILLE, AR 72701-2831
(479) 414-3219
(479) 301-2488
Mailing address
PO BOX 10830, FAYETTEVILLE, AR 72703-0049
(479) 414-3219
(479) 301-2488
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C00569
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100781500A
—
OK
05
—
120778701
—
AR
Enumeration date
09/15/2006
Last updated
09/26/2012
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