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

Registrant NPI Number: 1437465929

Individual Registrant:
Gender: F
Sole Proprietor

Location and contact information for practice:
11508 HIGHWAY 49 N  MARMADUKE, AR 72443-9558 US
Tel: 870-597-1319  Fax: 870-597-1320

Contact information for business:
11508 HIGHWAY 49 N  MARMADUKE, AR 72443-9558 US
Tel: 870-597-1319  Fax: 870-597-1320

Registration Information:
NPI: 1437465929
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
ARA03412 ANP

Legacy codes, insurance codes and state license numbers:



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