Individual
GRACEN LEE DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, NNP-BC
Contact information
Practice address
1 CHILDRENS WAY # 211, LITTLE ROCK, AR 72202-3500
(501) 364-1244
Mailing address
602 OLD HIGHWAY 11 S, HAZEN, AR 72064-9659
(870) 255-5044
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
221005
AR
Other
Enumeration date
08/09/2022
Last updated
11/17/2023
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