NPI 1154955797

Aniefiok Jacob

Practitioner Driver Jonesboro, AR

Practice location

Address: 3306 Shelby Dr, Jonesboro, AR 72404-0637
Phone: (870) 219-1692
Mailing address: 604 Fox Run Dr, Jonesboro, AR 72404-0511

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1154955797
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Feb 2020
Record last updated: 22 Feb 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.