Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | A004948 | AR |
NPI | 1033661798 |
---|---|
Provider Name | Amanda Cope |
First Address | Harrison, AR 72601-2913 |
Second Address | Harrison, AR 72601-2913 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2016 |
Last Update Date | 05/01/2022 |