| NPI | 1356981641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH M CARRINGTON Nurse Practitioner 479-757-0190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2020-01-14 |
| Last Update Date | 2021-07-27 |