Individual
TAMIETRA TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8302 GREYSTONE CV, ALEXANDER, AR 72002-8319
(501) 647-2072
Mailing address
8302 GREYSTONE CV, ALEXANDER, AR 72002-8319
(501) 647-2072
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
AR5879
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306874732
—
AR
Enumeration date
02/29/2024
Last updated
02/29/2024
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