Individual
KORI MCDANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3434 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4576
(479) 318-0122
Mailing address
16516 SANDSTONE, SPRINGDALE, AR 72764-8508
(479) 409-3786
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L055040
AR
Other
Enumeration date
10/03/2024
Last updated
10/03/2024
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