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NPI Code Detail

MEDICARE: JONES RISING STAR

MEDICARE: JONES RISING STAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency
2251J00000XNursing Care Agency
3163W00000XRegistered Nurse

General Provider Information

NPI Number : 1073390084
Entity Type Code : Organization
Provider Name (Legal Business Name) : JONES RISING STAR
Provider Business Mailing Address
First Line : 800 CLEMENT RD
Second Line :
City : WEST MEMPHIS
State : AR
Zip : 72301-2885
Country : US
Telephone Number : 870-635-7967
Fax Number :
Provider Business Practice Location Address
First Line : 800 CLEMENT RD
Second Line :
City : WEST MEMPHIS
State : AR
Zip : 72301-2885
Country : US
Telephone Number : 870-635-7967
Fax Number :
Authorized Official
Title or Position : CEO
Name : BEVERLY JONES
Credential : MBA, MSN, RN
Telephone Number : 870-635-7967
Provider Enumeration Date : 09/12/2023
Last Update Date : 09/12/2023

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Directions to “JONES RISING STAR ” Practice Location

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