Individual
CRYSTAL MANDY BROKAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2236 HARRISON ST, BATESVILLE, AR 72501-7417
(870) 847-2500
Mailing address
PO BOX 62, SAGE, AR 72573-0062
(870) 291-0727
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R087664
AR
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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