Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | E-5696 | AR |
NPI | 1356555379 |
---|---|
Provider Name | Dr. Jana Michele Ayres |
First Address | Rogers, AR 72758-1452 |
Second Address | Rogers, AR 72758-1452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 19/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5H271 | AR BCBS (01) | AR |