Individual provider · Type 1 NPI
Kim Jaquish, RNP
Gerontology Nurse Practitioner · Fort Smith, AR
NPI number
1245228485
Active
Practice location
1500 Dodson Ave, Ste 125
Fort Smith, AR 72901-5182
Fax (479) 573-7961
Mailing address
PO Box 402319
Atlanta, GA 30384-2319
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | P01373 (AR) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1245228485
Kim Jaquish, RNP's National Provider Identifier is 1245228485, issued on Oct 12, 2005. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Fort Smith, AR. The record was last updated on Aug 27, 2010.