Individual
MANUEL HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-6562
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT 203
AR
363LA2200X
Adult Health Nurse Practitioner
Primary
A004183
AR
Other
Enumeration date
06/17/2006
Last updated
09/25/2014
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