Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A005630 | AR |
NPI | 1003304213 |
---|---|
Provider Name | Brittany Huls |
First Address | Fayetteville, AR 72703-4424 |
Second Address | Fayetteville, AR 72703-4424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2018 |
Last Update Date | 02/05/2018 |