Individual
MRS. TINA LOUISE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3307 N DIXIELAND RD, ROGERS, AR 72756-6816
(479) 986-5150
(479) 986-5191
Mailing address
PO BOX 130, ROGERS, AR 72757-0130
(479) 986-5150
(479) 986-5191
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L039606
AR
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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