Provider Demographics
NPI:1417247628
Name:PULLEN, JESSICA ADAMS (MD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ADAMS
Last Name:PULLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 UNITED DR STE 420
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-7826
Mailing Address - Country:US
Mailing Address - Phone:501-358-6941
Mailing Address - Fax:501-358-6951
Practice Address - Street 1:625 UNITED DR STE 420
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7826
Practice Address - Country:US
Practice Address - Phone:501-358-6941
Practice Address - Fax:501-358-6941
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-10
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE9233207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology