Provider Demographics
NPI:1881016947
Name:ASBERY, JENNIFER LYNN (MS, ATC)
Entity Type:Individual
Prefix:MISS
First Name:JENNIFER
Middle Name:LYNN
Last Name:ASBERY
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31816 MARIES ROAD 218
Mailing Address - Street 2:
Mailing Address - City:META
Mailing Address - State:MO
Mailing Address - Zip Code:65058-3119
Mailing Address - Country:US
Mailing Address - Phone:573-619-8142
Mailing Address - Fax:
Practice Address - Street 1:401 N. LINCOLN
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3119
Practice Address - Country:US
Practice Address - Phone:501-743-3541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAT 5272255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer