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1063069326
TARA RAE SANDUSKY
FORT SMITH, AR
NPI
1063069326
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Former Name
TARA RAE HATTABAUGH
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: AR 121897)
Enumeration Date
2019-08-21
Last Update Date
2019-09-05
Business Address
TARA RAE SANDUSKY APRN
1001 TOWSON AVE
FORT SMITH, AR 72901-4921
Phone number: 479-441-5005
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Mailing Address
TARA RAE SANDUSKY APRN
1001 TOWSON AVE
FORT SMITH, AR 72901-4921
Phone number: 479-441-4000
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