Individual
MISTY WALTHALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
560 MARYWOOD, WARD, AR 72176-7809
(501) 772-6595
Mailing address
560 MARYWOOD, WARD, AR 72176-7809
(501) 772-6595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R072312
AR
Other
Enumeration date
02/21/2016
Last updated
02/21/2016
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