Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist | 171M00000X | AR |
NPI | 1144633678 |
---|---|
Provider Name | Kedecia Neyland |
First Address | Bryant, AR 72022-8327 |
Second Address | Bryant, AR 72022-8327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 02/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
N/A | (05) | AR |