Individual
JULISSA L LYNN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 CENTERVIEW CT, SEARCY, AR 72143
(501) 593-3893
Mailing address
105 CENTERVIEW CT, SEARCY, AR 72143-8975
(501) 593-3893
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R80717
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9125572174
DRIVER LICENSE NUMBER
AR
Enumeration date
02/27/2014
Last updated
02/27/2014
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