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Individual

VENITA LYNNE NINEMIRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
673 NORTH MAIN ST, SALEM, AR 72576
(870) 895-2152
Mailing address
PO BOX 517, SALEM, AR 72576-0517
(870) 895-6096

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A005438
AR
363LF0000X
Family Nurse Practitioner
A005438
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A005438
LICENSE
AR
Enumeration date
01/12/2018
Last updated
12/10/2024
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