Individual
ROSE ARCHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2511 E 24TH ST APT 1, TEXARKANA, AR 71854-4058
(903) 293-1256
Mailing address
2511 E 24TH ST APT 1, TEXARKANA, AR 71854-4058
(903) 293-1256
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L041100
AR
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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