Individual
JENNIFER M MANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
808 SOUTH 52ND STREET, ROGERS, AR 72758-8602
(479) 936-9900
(479) 587-1366
Mailing address
3232 N NORTH HILLS BLVD, FAYETTEVILLE, AR 72703-4005
(479) 587-1700
(479) 587-1366
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A03532
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190323758
—
AR
05
—
1962701466
—
MO
05
—
200408730A
—
OK
Enumeration date
03/23/2011
Last updated
03/30/2020
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