| Doctor Name: | JARROD JERRY |
| NPI Number: | 1407143662 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | A.P.N. |
| License Number: | A03531 |
| Business Practice Address: | 110 N Broadview St Greenbrier, AR - 720589475 |
| Business Phone Number: | 5016793551 |
| Business Fax Number: | |
| Mailing Address: | P.o. Box 476, 110 N. Broadview Street GREENBRIER |
| State: | AR |
| Postal Code: | 720580476 |
| Phone Number: | 5016793551 |
| Fax Number: | |
| NPI Enumeration Date: | 07/07/2011 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A03531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |