Individual
JACQUELINE DEENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 SW MODERN WAY APT 201, BENTONVILLE, AR 72713-2032
(860) 575-7255
Mailing address
3700 SW MODERN WAY APT 201, BENTONVILLE, AR 72713-2032
(860) 575-7255
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
140207
CT
363LF0000X
Family Nurse Practitioner
12.012403
CT
363LF0000X
Family Nurse Practitioner
Primary
230037
AR
Other
Enumeration date
02/14/2023
Last updated
11/07/2024
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