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General NPI Number Information
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NPI Number | 1841890605
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Entity Type | Individual
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Provider Name | JENNIFER MAINALI
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Gender | Female
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Dates
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Enumeration Date | 10/29/2020
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 5600 LANDERS RD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72117-1903
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Country | US
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Telephone | 501-955-9451
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Fax |
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Provider Business Mailing Address
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Address Line | 303 BURNTWOOD ST
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City | SHERWOOD
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State | AR
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Zip | 72120-5514
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Country | US
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Telephone | 501-206-1895
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD11672
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License Number State | AR
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