Individual
CHARLYN SUE HACKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
402 S LEE ST, HAMPTON, AR 71744-8615
(870) 798-4064
Mailing address
14016 JOAN DR, MABELVALE, AR 72103-3085
(870) 818-0014
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216422
AR
Other
Enumeration date
06/07/2021
Last updated
07/07/2021
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