Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 68281 | OK |
Y | 363LW0102X | Nurse Practitioner - Women's Health | A003077 | AR |
N | 363LW0102X | Nurse Practitioner - Women's Health | R751003 | MS |
NPI | 1033382684 |
---|---|
Provider Name | Julia Laverne Furniss-Roberts |
First Address | Centerton, AR 72719-9413 |
Second Address | Springdale, AR 72764-4634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2008 |
Last Update Date | 01/02/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
177023758 | (05) | AR |
200543710A | (05) | OK |