Healthcare Provider Details

I. General information

NPI: 1184237794
Provider Name (Legal Business Name): JENNIFER BEISKER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JADE WICKES D.C.

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 CARRIE DR
BENTON AR
72019-7385
US

IV. Provider business mailing address

8420 CARRIE DR
BENTON AR
72019-7385
US

V. Phone/Fax

Practice location:
  • Phone: 501-701-7235
  • Fax:
Mailing address:
  • Phone: 501-701-7235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC2248
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number12471
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: