Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 290 | AR |
Y | 222Z00000X | Podiatrist | 290 | AR |
N | 213E00000X | Podiatrist | 306037 | LA |
N | 222Z00000X | Podiatrist | 306037 | LA |
NPI | 1023538568 |
---|---|
Provider Name | Megan Lynn Herring |
First Address | Little Rock, AR 72212-2458 |
Second Address | Little Rock, AR 72212-2458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2017 |
Last Update Date | 29/09/2020 |