Mandy Koekemoer
Nurse Practitioner, Family in Jonesboro, AR. Individual provider (NPI-1).
NPI number1164086559
StatusActive
Last updated in NPPESNov 6, 2022
Details
- NPI
- 1164086559
- Entity type
- Individual (NPI-1)
- Name
- Mandy Koekemoer
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 1, 2019
- Certification date
- Nov 6, 2022
- Last updated
- Nov 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 222001 | AR | Yes |
| 163W00000X | Registered Nurse | R69806 | AR |
Practice location
4713 Winged Foot LnJonesboro, AR 72405-8050
Phone 870-243-0418
Mailing address
4713 Winged Foot LnJonesboro, AR 72405-8050
Phone 870-243-0418
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