Healthcare Provider Details

I. General information

NPI: 1851858773
Provider Name (Legal Business Name): JESSICA M WOMBLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 PONCE DE LEON DR
HOT SPRINGS VILLAGE AR
71909-8143
US

IV. Provider business mailing address

PO BOX 1960
JONESBORO AR
72403-1960
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-1700
  • Fax: 501-922-0826
Mailing address:
  • Phone: 870-936-8000
  • Fax: 870-932-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA006149
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: