Individual
THERESA FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Mailing address
2740 COLLEGE AVE, CONWAY, AR 72034-6141
(501) 329-5459
(501) 327-1738
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R44204
AR
Other
Enumeration date
05/02/2011
Last updated
05/02/2011
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