Doctor Name: | JENNIFER YORK |
NPI Number: | 1609244995 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | A004497 |
Business Practice Address: | 127 River Valley Loop Maumelle, AR - 721137137 |
Business Phone Number: | 5019936688 |
Business Fax Number: | |
Mailing Address: | 127 River Valley Loop, MAUMELLE |
State: | AR |
Postal Code: | 72113 |
Phone Number: | 5019936688 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2015 |
NPI Last Update Date: | 09/03/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0222X |
License Number: | A004497 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics, Critical Care |
Taxonomy Definition: |