Individual
MALLORY RUTH WISDOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1233 W POPLAR ST, ROGERS, AR 72756-4245
(479) 636-9235
(479) 751-2878
Mailing address
907 N 34TH ST, ROGERS, AR 72756-9151
(870) 362-0914
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
216033
AR
Other
Enumeration date
12/04/2024
Last updated
07/30/2025
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