Jillian Harris

Individual provider Active NPI Family Health Clinical Nurse Specialist · Earle, AR

NPI 1104293018 · NPPES record last updated Aug 26, 2015

Key facts

NPI
1104293018
Entity type
Individual (NPI type 1)
Primary specialty
Family Health Clinical Nurse Specialist 364SF0001X
License
A004527 (AR)
Practice address
1605 2ND St
Earle, AR 72331-1634
Phone
(870) 633-8825
NPI assigned
Aug 26, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
A004527ARMDFamily Health Clinical Nurse Specialist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Health Clinical Nurse Specialist 364SF0001X A004527 AR Yes

Addresses

Primary practice location

1605 2ND St
Earle, AR 72331-1634

Mailing address

332 E Cook St
Forrest City, AR 72335-2830

Other providers in Earle, AR

All providers in Earle, AR · Family Health Clinical Nurse Specialist in Arkansas

Sources for this page

Verify at the official NPI Registry.