Latasha Rena Van Heflin
Driver in Springdale, AR. Individual provider (NPI-1).
NPI number1982205043
StatusActive
Last updated in NPPESNov 5, 2020
Details
- NPI
- 1982205043
- Entity type
- Individual (NPI-1)
- Name
- Latasha Rena Van Heflin
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 5, 2020
- Certification date
- Nov 5, 2020
- Last updated
- Nov 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 172A00000X | Driver | – | – | Yes |
Practice location
1268 Electric AveSpringdale, AR 72764-7498
Phone 870-336-8100
Mailing address
3127 Southwest DrJonesboro, AR 72404-8404
Phone 870-336-8100
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