Individual
TRACY LYNNE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6262 HIGHWAY 316 S, MARVELL, AR 72366-9439
(870) 714-0453
Mailing address
6262 HIGHWAY 316 S, MARVELL, AR 72366-9439
(870) 714-0453
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A005840
AR
Other
Enumeration date
08/24/2018
Last updated
08/24/2018
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