Individual
LIBERTY B NEOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
128 DANIEL DR, BOONEVILLE, AR 72927-0128
(479) 675-2455
(479) 675-4940
Mailing address
2901 S 74TH ST, FORT SMITH, AR 72903-5156
(314) 364-7595
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A005369
AR
Other
Enumeration date
09/27/2017
Last updated
09/27/2017
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