Individual
MRS. CARRISA SUZETTE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6108 S 31ST ST, FORT SMITH, AR 72908-7555
(479) 242-9355
Mailing address
9425 W HIGHWAY 248, WALDRON, AR 72958-8639
(501) 802-0072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005820
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A005820
APRN LICENSE
AR
Enumeration date
08/06/2018
Last updated
08/02/2024
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