Healthcare Provider Details

I. General information

NPI: 1255162764
Provider Name (Legal Business Name): JULIA JARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20820 I 30 N
BENTON AR
72019
US

IV. Provider business mailing address

15401 CHENAL PKWY APT 2310
LITTLE ROCK AR
72211-2561
US

V. Phone/Fax

Practice location:
  • Phone: 501-574-3884
  • Fax:
Mailing address:
  • Phone: 870-265-0915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD17087
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: