Healthcare Provider Details

I. General information

NPI: 1043143266
Provider Name (Legal Business Name): DOE JANE LESTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8009 OXFORD CIR
FORT SMITH AR
72903-4230
US

IV. Provider business mailing address

8009 OXFORD CIR
FORT SMITH AR
72903-4230
US

V. Phone/Fax

Practice location:
  • Phone: 479-310-5709
  • Fax:
Mailing address:
  • Phone: 479-310-5709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number124489
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: