Healthcare Provider Details

I. General information

NPI: 1275449837
Provider Name (Legal Business Name): JESSICA ELIZABETH JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 OAK ST
WARREN AR
71671-2144
US

IV. Provider business mailing address

404 OAK ST
WARREN AR
71671-2144
US

V. Phone/Fax

Practice location:
  • Phone: 870-466-8884
  • Fax:
Mailing address:
  • Phone: 870-466-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number234453
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: