Individual
ALYSSON BLYTHE GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1102 NW LOWES AVE STE 2, BENTONVILLE, AR 72712-4978
(479) 254-8563
Mailing address
1102 NW LOWES AVE STE 2, BENTONVILLE, AR 72712-4978
(479) 254-8563
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005601
AR
Other
Enumeration date
04/03/2018
Last updated
09/15/2020
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