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WAKETTA LASHELLE ALDRIDGE APRN

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

Registrant NPI Number: 1588297972

Individual Registrant:
 WAKETTA LASHELLE ALDRIDGE APRN
Gender: F
Not Sole Proprietor

Location and contact information for practice:
300 CORRECTIONS DR  NEWPORT, AR 72112-8008 US
Tel: 870-523-5877  Fax: --

Contact information for business:
2506 TAYLOR MCQUEEN PL  JONESBORO, AR 72404-9363 US
Tel: 870-273-4010  Fax: --

Registration Information:
NPI: 1588297972
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LG0600XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Gerontology
AR122838

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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