Individual
LYDIA M TEAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 HOSPITAL DR, MORRILTON, AR 72110
(501) 977-2300
(501) 977-2256
Mailing address
4 HOSPITAL DR, MORRILTON, AR 72110
(501) 977-2300
(501) 977-2256
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R25489
AR
367500000X
Certified Registered Nurse Anesthetist
Primary
C00401
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136786701
—
AR
Enumeration date
07/24/2006
Last updated
04/20/2010
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