Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | A004066 | AR |
NPI | 1003015348 |
---|---|
Provider Name | Yolonda E Reed |
First Address | Pleasant Plains, AR 72568-0450 |
Second Address | Pleasant Plains, AR 72568 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2007 |
Last Update Date | 06/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A004066 | ARKANSAS (01) | AR |
S20976 | (02) | AR |