Individual
MICHELLE HARSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6701 HIGHWAY 67, BENTON, AR 72015-8909
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L26910
AR
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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