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Individual

MRS. ALEX ELAINE MATLOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
6 SHACKLEFORD DR, LITTLE ROCK, AR 72211-2858
(501) 500-5001
Mailing address
6 SHACKLEFORD DR, LITTLE ROCK, AR 72211-2858
(501) 500-5001

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A006101
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A006101
ARKANSAS CERTIFIED NURSE PRACTITIONER
AR
Enumeration date
02/23/2019
Last updated
06/10/2019
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