Individual
KISTY TANEIL WINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 SE 9TH ST, ENGLAND, AR 72046-2205
(501) 326-0092
Mailing address
12100 FIELDSTONE LN APT E22, BRYANT, AR 72022-6248
(501) 326-0092
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
AR
Other
Enumeration date
04/06/2026
Last updated
04/06/2026
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