Individual
JANA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1308 W 5TH AVE, CROSSETT, AR 71635-2500
(870) 364-6471
Mailing address
790 ROBERTS DR, MONTICELLO, AR 71655-5723
(870) 367-2461
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
L060210
AR
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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