Healthcare Provider Details

I. General information

NPI: 1821579061
Provider Name (Legal Business Name): ARLENE ALDONA JENNINGS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2018
Last Update Date: 08/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5223 INDIAN SPRINGS RD
TEMPLE TX
76502-6519
US

IV. Provider business mailing address

5223 INDIAN SPRINGS RD
TEMPLE TX
76502-6519
US

V. Phone/Fax

Practice location:
  • Phone: 254-231-8111
  • Fax:
Mailing address:
  • Phone: 254-231-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number583022
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: