Healthcare Provider Details

I. General information

NPI: 1629236435
Provider Name (Legal Business Name): MARY PRICE JONES APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY BALCH PRICE

II. Dates (important events)

Enumeration Date: 05/29/2008
Last Update Date: 03/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

IV. Provider business mailing address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-5226
  • Fax:
Mailing address:
  • Phone: 501-257-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License NumberAO1385
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: