Provider Demographics
NPI:1396573119
Name:DABBS, JENNIFER LEIGH (APRN)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH
Last Name:DABBS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 WOODLAND PARK RD
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022-6667
Mailing Address - Country:US
Mailing Address - Phone:501-467-6529
Mailing Address - Fax:
Practice Address - Street 1:4430 HIGHWAY 5 N STE 6
Practice Address - Street 2:
Practice Address - City:BRYANT
Practice Address - State:AR
Practice Address - Zip Code:72022-7047
Practice Address - Country:US
Practice Address - Phone:501-847-2835
Practice Address - Fax:501-847-3802
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR229700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily