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ELIZABETH LEANNE WALLIS APN

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1740528546

Individual Registrant:
 ELIZABETH LEANNE WALLIS APN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
146 HWY 32-2A  ASHDOWN, AR 71822-8689 US
Tel: 870-898-5525  Fax: --

Contact information for business:
146 HWY 32-2A  ASHDOWN, AR 71822-8689 US
Tel: 870-898-5525  Fax: --

Registration Information:
NPI: 1740528546
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
ARA01706

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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