Provider Demographics
NPI:1609487024
Name:RENO, JANA LEIGHETTE
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:LEIGHETTE
Last Name:RENO
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 1:7303 ROGERS AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4105
Mailing Address - Country:US
Mailing Address - Phone:479-452-1188
Mailing Address - Fax:479-452-1196
Practice Address - Street 1:7303 ROGERS AVE STE 302
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4105
Practice Address - Country:US
Practice Address - Phone:479-452-1188
Practice Address - Fax:479-452-1196
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant