Arkansas Mobile Wound Management PLLC
Nurse Practitioner in Benton, AR. Organization (NPI-2).
NPI number1871348441
StatusActive
Last updated in NPPESMay 3, 2024
Details
- NPI
- 1871348441
- Entity type
- Organization (NPI-2)
- Legal business name
- Arkansas Mobile Wound Management PLLC
- Organization subpart
- No
- Enumeration date
- Apr 18, 2024
- Certification date
- May 3, 2024
- Last updated
- May 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | – | – | Yes |
| 208D00000X | General Practice | – | – | |
| 261Q00000X | Clinic/Center | – | – |
Practice location
7509 S Shoreline BlvdBenton, AR 72019-8473
Phone 501-602-8979
Mailing address
7509 S Shoreline BlvdBenton, AR 72019-8473
Authorized official
Holly Balogh
Owner
5016028979
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