Individual
MRS. DERRICA CONKLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3359 W CORNELL DR, FAYETTEVILLE, AR 72704-6775
(479) 200-8054
Mailing address
3359 W CORNELL DR, FAYETTEVILLE, AR 72704-6775
(479) 200-8054
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
AR
Other
Enumeration date
07/13/2015
Last updated
07/13/2015
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