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Individual

MS. KATHLEEN M MAPLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
200 W TYLER AVE, WEST MEMPHIS, AR 72301-4223
(501) 658-2718
(501) 724-3305
Mailing address
485 HWY 124, PO BOX 153, PANGBURN, AR 72121
(501) 658-2718

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A02928
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
164961758
AR
Enumeration date
11/30/2006
Last updated
06/12/2009
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