| NPI | 1225257017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON A HARTER Clinic Manager 501-225-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR E1505) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A01721) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2007-12-05 |