Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Skin Dermatology Practitioner, PLLC

Organization Nurse Practitioner · NPI 1003505389

Skin Dermatology Practitioner, PLLC is a Nurse Practitioner in Jonesboro, Arkansas. Registered with an NPI since 2023.

In the registry since
2023
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3106 SW Dr Ste 103
Jonesboro, AR 72404-8404
Phone: (870) 641-7546
Fax: (870) 641-7547
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1003505389
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nancy Pemberton — Authorized Official · (708) 530-2453
NPI enumeratedMay 3, 2023
Last updated in NPPESJune 21, 2023
Certification dateJune 21, 2023
Mailing addressPo Box 9178, Russellville, AR 72811-9178

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