Individual
TARA RAE SANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-5005
Mailing address
1001 TOWSON AVE, FORT SMITH, AR 72901-4921
(479) 441-4000
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
121897
AR
Other
Enumeration date
08/21/2019
Last updated
09/05/2019
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