Individual
JENNIFER DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
205 INGRAM BLVD, WEST MEMPHIS, AR 72301-3423
(870) 735-2737
(870) 735-2738
Mailing address
205 INGRAM BLVD, WEST MEMPHIS, AR 72301-3423
(870) 735-2737
(870) 735-2738
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L28853
AR
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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