Jamie Keith Pettus in Benton - Licensed Practical Nurse
Jamie Keith Pettus - NPI 1417141920
Jamie Keith Pettus is a Licensed Practical Nurse in Benton, Arkansas. Jamie Keith Pettus practices all healthcare services and medical treatments related to Licensed Practical Nurse. The NPI Number for Jamie Keith Pettus is 1417141920. The last update date is 2009-10-12.
Jamie Keith Pettus's current location address is 6701 Highway 67 Bldg 70, Benton, Arkansas. You can contact this provider via phone number 5013153344 and fax number 5013033186. The mailing address for Jamie Keith Pettus is 6701 Highway 67 Bldg 70, Benton, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jamie Keith Pettus |
|---|---|
| Address | 6701 Highway 67 Bldg 70, Benton, Arkansas |
| Phone Number | 5013153344 |
| Fax Number | 5013033186 |
| Sole Proprietor | N |
| Credentials | LPN |
NPI Number Detail
| NPI Number | 1417141920 |
|---|---|
| Provider Enumeration Date | 2007-08-29 |
| Last Updated Date | 2009-10-12 |
Provider Mailing Address Detail
| Address | 6701 Highway 67 Bldg 70 |
|---|---|
| City | Benton |
| State | Arkansas (AR) |
| Post Code | 720158909 |
| Phone Number | 5013153344 |
| Fax Number | 5013033186 |
Provider's Primary Taxonomy Detail
| Speciality | Licensed Practical Nurse |
|---|---|
| Taxonomy | 164W00000X |
| Licence No | L38028 |
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Definition: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job r |
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Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jamie Keith Pettus by the Centers for Medicare & Medicaid Services?
The Jamie Keith Pettus has been issued the NPI (National Provider Identifier) 1417141920, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Jamie Keith Pettus?
The Jamie Keith Pettus is situated at 6701 Highway 67 Bldg 70, in the city of Benton, state of AR, with the zip code 720158909.
What is Jamie Keith Pettus's area of expertise and its corresponding taxonomy classification?
The Jamie Keith Pettus's field of specialization is Licensed Practical Nurse, and it falls under the taxonomy code 164W00000X, which categorizes healthcare providers based on their areas of practice.
On what date did Jamie Keith Pettus receive its 1417141920 assignment from the Centers for Medicare & Medicaid Services?
The Jamie Keith Pettus was assigned its 1417141920 on 2007-08-29, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Jamie Keith Pettus, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Jamie Keith Pettus, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2009-10-12.
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