| Knew Mindset Llc | |
|
944 State Highway 77 Marion AR 72364-9004 | |
| (870) 821-0315 | |
| Not Available |
| Full Name | Knew Mindset Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 944 State Highway 77, Marion, Arkansas |
| Authorized Official Name and Position | Jaleesa Shears (OWNER) |
| Authorized Official Contact | 8705599144 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Knew Mindset Llc Po Box 1530 Marion AR 72364-1539 Ph: (870) 559-9144 | Knew Mindset Llc 944 State Highway 77 Marion AR 72364-9004 Ph: (870) 821-0315 |
| NPI Number | 1639822828 |
|---|---|
| Provider Enumeration Date | 01/28/2022 |
| Last Update Date | 02/24/2024 |
| Certification Date | 02/24/2024 |
| Medicare PECOS PAC ID | 5890160469 |
|---|---|
| Medicare Enrollment ID | O20230412003105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639822828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | (* (Not Available)) | Primary |
| Provider Name | Jaleesa Shears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508478066 PECOS PAC ID: 5294148961 Enrollment ID: I20210120000104 |
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