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1245228485
KIM JAQUISH
FORT SMITH, AR
NPI
1245228485
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LG0600X Nurse Practitioner, Gerontology
(Licence: AR P01373)
Enumeration Date
2005-10-12
Last Update Date
2010-08-27
Business Address
-- KIM JAQUISH RNP
1500 DODSON AVE STE 125
FORT SMITH, AR 72901-5182
Phone number: 479-573-7960
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Mailing Address
-- KIM JAQUISH RNP
PO BOX 402319
ATLANTA, GA 30384-2319
Phone number: 479-709-7399
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