Healthcare Provider Details

I. General information

NPI: 1689504599
Provider Name (Legal Business Name): HANNAH LORANE JESSUP DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E WASHINGTON AVE
JONESBORO AR
72401-3111
US

IV. Provider business mailing address

PO BOX 287
LAKE CITY AR
72437-0287
US

V. Phone/Fax

Practice location:
  • Phone: 870-207-4100
  • Fax:
Mailing address:
  • Phone: 501-359-7636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number237360
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: