Individual
JENNIFER HALLIBURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 N JACKSON ST, CABOT, AR 72023-3058
(501) 941-3522
(501) 941-3525
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534
(870) 347-3492
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004005
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200980758
—
AR
Enumeration date
02/03/2014
Last updated
07/21/2022
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