Individual
BONITA LOIS MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
500 E COLLIN RAYE DR, DE QUEEN, AR 71832-8048
(870) 584-1055
Mailing address
358 BRIDGE CREEK RD, HORATIO, AR 71842-9000
(870) 784-2729
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
123723
AR
Other
Enumeration date
01/06/2020
Last updated
02/11/2020
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