Individual
MRS. CARRIE DARLENE FENDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
620 W SOUTH ST STE B, BENTON, AR 72015-4235
(501) 860-7150
(501) 860-7166
Mailing address
PO BOX 497, AUGUSTA, AR 72006-0497
(870) 347-2534
(870) 347-2023
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003402
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185317758
—
AR
Enumeration date
07/13/2010
Last updated
02/11/2019
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