Jeanette D Ross, PROVIDER ENROLLMENT

NPI #1700608684 in Ozark, Arkansas

Provider Information

NPI Number: 1700608684
Entity Type: Individual
Name: Jeanette D Ross, PROVIDER ENROLLMENT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Homemaker
Credential: PROVIDER ENROLLMENT
Enumeration Date: Oct 30, 2024
Last Updated: Oct 30, 2024

Practice Location

Address: PO BOX 1015
City: Ozark
State: Arkansas
ZIP Code: 72949-1015
Phone: (479) 209-6471

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Homemaker	376J00000X	Primary

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