Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 212540 | AR |
NPI | 1013515857 |
---|---|
Provider Name | Crystal Nicole Rowton |
First Address | Glenwood, AR 71943-9183 |
Second Address | Hot Springs Village, AR 71909-4093 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2020 |
Last Update Date | 14/10/2020 |