Provider Demographics
NPI:1578853818
Name:JAMES, JESSIE L
Entity Type:Individual
Prefix:MISS
First Name:JESSIE
Middle Name:L
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E SUMAC ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-6036
Mailing Address - Country:US
Mailing Address - Phone:479-313-4214
Mailing Address - Fax:
Practice Address - Street 1:708 E SUMAC ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-6036
Practice Address - Country:US
Practice Address - Phone:479-313-4214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide