Healthcare Provider Details

I. General information

NPI: 1205397296
Provider Name (Legal Business Name): JASON STEIMEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2019
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E JACKSON AVE
JONESBORO AR
72401-3119
US

IV. Provider business mailing address

3501 BURDYSHAW DR
JONESBORO AR
72401-8732
US

V. Phone/Fax

Practice location:
  • Phone: 870-207-1000
  • Fax:
Mailing address:
  • Phone: 479-530-4556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number120300
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: