Individual
FALLON E WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 COMMERCIAL CENTER DR STE 1, MARION, AR 72364-9616
(901) 496-0071
Mailing address
4001 COMMERCIAL CENTER DR STE 1, MARION, AR 72364-9616
(901) 496-0071
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A004461
AR
Other
Enumeration date
08/04/2015
Last updated
09/17/2020
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