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General NPI Number Information
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NPI Number | 1184181216
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Entity Type | Individual
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Provider Name | JENNIFER ANNE JULIAN APRN
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Gender | Female
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Dates
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Enumeration Date | 02/25/2019
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 6801 ROGERS AVE FL 2
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City | FORT SMITH
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State | AR
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Zip | 72903-4067
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Country | US
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Telephone | 479-274-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 2802 BOLLINGER RD
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City | CHARLESTON
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State | AR
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Zip | 72933-3337
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Country | US
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Telephone | 479-561-1354
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A006082
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License Number State | AR
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