Individual
KASEY OLIVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 SOUTH DR LOT 22A, GREERS FERRY, AR 72067-4800
(305) 680-2295
Mailing address
119 CONRAD DR, HIGDEN, AR 72067-9208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L055953
AR
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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