Individual
AMANDA CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
16832 PRINCE RD, CANEHILL, AR 72717-9415
(479) 220-1513
Mailing address
16832 PRINCE RD, CANEHILL, AR 72717-9415
(479) 220-1513
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
124084
AR
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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