Charlene Mae Jaques, APN
Nurse Practitioner in Farmington, AR. Individual provider (NPI-1).
NPI number1376373761
StatusActive
Last updated in NPPESDec 2, 2024
Details
- NPI
- 1376373761
- Entity type
- Individual (NPI-1)
- Name
- Charlene Mae Jaques
- Credential
- APN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 1, 2024
- Certification date
- Dec 2, 2024
- Last updated
- Dec 2, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 229879 | AR | Yes |
| 207Q00000X | Family Medicine | 229879 | AR |
Practice location
11112 Shumate Crossing RdFarmington, AR 72730-8792
Phone 479-856-9363
Mailing address
11112 Shumate Crossing RdFarmington, AR 72730-8792
Phone 479-856-9363
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