Provider Demographics
NPI:1790299220
Name:CONREY, JAMMIE M (RN)
Entity Type:Individual
Prefix:MRS
First Name:JAMMIE
Middle Name:M
Last Name:CONREY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 SW THIRD ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT RIDGE
Mailing Address - State:AR
Mailing Address - Zip Code:72476-2308
Mailing Address - Country:US
Mailing Address - Phone:870-637-5903
Mailing Address - Fax:
Practice Address - Street 1:1801 GRANT AVE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-6155
Practice Address - Country:US
Practice Address - Phone:870-974-9128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR090308163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse