Individual
KAYTI DANIELLE BROOKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
551 SPENCER LOOP, MAYNARD, AR 72444-8501
(870) 378-0962
Mailing address
551 SPENCER LOOP, MAYNARD, AR 72444-8501
(870) 378-0962
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L059973
AR
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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