Individual
KHEM NOUANSAVANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
7001 ROGERS AVE STE 401A, FORT SMITH, AR 72903-4034
(479) 314-4650
(479) 452-4650
Mailing address
7001 ROGERS AVE STE 401A, FORT SMITH, AR 72903-4034
(479) 314-4650
(479) 452-9459
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A004913
AR
Other
Enumeration date
10/19/2016
Last updated
04/04/2019
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