Individual
REBECCA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE
Contact information
Practice address
8109 INTERSTATE 30, LITTLE ROCK, AR 72209-4840
(501) 562-5400
Mailing address
8109 INTERSTATE 30, LITTLE ROCK, AR 72209-4840
(501) 562-5400
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
R095143
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
NURSE
—
Enumeration date
10/17/2017
Last updated
10/17/2017
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