Individual
DR. JUAN DIEGO VICTORIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005197
AR
Other
Enumeration date
03/31/2015
Last updated
09/08/2020
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