Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | A01472 | AR |
NPI | 1013928753 |
---|---|
Provider Name | Linda Fletcher |
First Address | Benton, AR 72015-6101 |
Second Address | Little Rock, AR 72205-5446 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |