MS. MANDI LYN FAIR (NPI# 1073162368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073162368 |
| Entity Type | Individual |
| Full Name | MS. MANDI LYN FAIR |
| Credential | LPN |
| Practice Address |
2707 Browns Ln Jonesboro AR 72401-7213 |
| Practice Telephone | 8709724939 |
| Practice Fax Number | 8709724911 |
| Mailing Telephone | 8709724050 |
| Mailing Fax Number | 8709724018 |
| Enumeration Date | 2019-09-09 |
| Last Update Date | 2019-09-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | L048800 | AR | Nursing Service Providers |
| Street Address |
2707 BROWNS LN |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-7213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669447702 | Jyothsna Kumar | Psychiatry & Neurology | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2006-02-22 |
| 1043823552 | Sheila Mckenzie | Behavior Technician | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-08-25 |
| 1245841592 | Skyler Prunty | Behavior Technician | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-08-11 |
| 1053922302 | Matheu Turner | Behavior Technician | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-08-11 |
| 1245841576 | Tatyana Barber | Behavior Technician | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-08-11 |
| 1124643903 | Grace Williams | Behavior Technician | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-06-08 |
| 1679106231 | Arthur Paul Bruce | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-02-21 |
| 1619500139 | Antonio Carlos De Almeida Dos Santos | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-02-13 |
| 1518599091 | Marcie L Tuggle | Nurse Practitioner | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-02-12 |
| 1215568522 | Jessica Aubrie Dacus | Case Manager/Care Coordinator | 2707 Browns Ln, Jonesboro, AR 72401-7213 | 2020-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366070047 | Bridgette Taylor | Licensed Practical Nurse | 9396 Fairfield Pkwy, Jonesboro, GA 30236-7408 | 2020-03-30 |
| 1578909503 | Naniek Simpson | Licensed Practical Nurse | 701 Mount Zion Rd, Apt 1902, Jonesboro, GA 30236-1533 | 2013-05-16 |
| 1013103654 | Bianca Marie Webb | Licensed Practical Nurse | 711 Lakeview Way, Jonesboro, GA 30238-5661 | 2007-09-18 |
| 1760524466 | Crystal D Guevara | Licensed Practical Nurse | 262 Southwest Dr, Jonesboro, AR 72401-5829 | 2007-02-12 |
| 1407461445 | Kathryn Taylor | Licensed Practical Nurse | 3700 Access Rd, Jonesboro, AR 72401-8225 | 2020-09-15 |
| 1578100574 | Christopher Scott Hodges | Licensed Practical Nurse | 3700 Access Rd, Jonesboro, AR 72401-8225 | 2019-12-09 |
| 1508401829 | Karmen Marie Esquivel | Licensed Practical Nurse | 3700 Access Rd, Jonesboro, AR 72401-8225 | 2019-11-11 |
| 1891338513 | Lauren Gayle Smith | Licensed Practical Nurse | 837 Willett Road, Jonesboro, AR 72401-7240 | 2019-10-25 |
| 1437791290 | Sarah K Gillis | Licensed Practical Nurse | 837 Willett Road, Jonesboro, AR 72401 | 2019-10-14 |
| 1578105755 | Megan Brooke Bass | Licensed Practical Nurse | 3700 Access Rd, Jonesboro, AR 72401-8225 | 2019-10-09 |
| Find all providers in JONESBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.