| NPI | 1225289978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE KINCAID Practice Manager 479-394-5068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A01300-ANP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AR A03080ANP) |
| 207Q00000X Family Medicine (Licence: AR N6236) | |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2013-11-25 |