=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417824368
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNIFER KAYE BARNES APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2025
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5315 W 12TH ST
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72204-1858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-664-0941
-----------------------------------------------------
Fax | 501-666-3956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3096 GLASGOW DR
-----------------------------------------------------
City | BENTON
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72015-6092
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-313-2252
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 234436
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------