Provider Demographics
NPI:1962584359
Name:LEEK, JOVANN (RN)
Entity type:Individual
Prefix:
First Name:JOVANN
Middle Name:
Last Name:LEEK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2578
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72503-2578
Mailing Address - Country:US
Mailing Address - Phone:870-793-8900
Mailing Address - Fax:870-793-4258
Practice Address - Street 1:200 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:AR
Practice Address - Zip Code:72650
Practice Address - Country:US
Practice Address - Phone:870-448-3724
Practice Address - Fax:870-448-3535
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR17923163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult