Individual
MRS. AMANDA TENILLE RAULS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3 MEDICAL PLZ, MOUNTAIN HOME, AR 72653-2918
(870) 424-3400
(870) 424-4121
Mailing address
162 AUGUSTA CIRCLE, MOUNTAIN HOME, AR 72653
(501) 231-3011
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A02992
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163346758
—
AR
Enumeration date
03/21/2007
Last updated
01/19/2016
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