Organization
THE CLINIC AT THE FORGING PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE FERGESON (CREDENTIALING/ OFFICE ADMINISTRATOR)
(479) 777-8510
Entity
Organization
Contact information
Practice address
1302 CHERRY ST, VAN BUREN, AR 72956-4543
(479) 310-9096
(479) 777-8510
Mailing address
1302 CHERRY ST, VAN BUREN, AR 72956-4543
(479) 310-9096
(479) 777-8510
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/26/2020
Last updated
08/26/2020
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