Individual
KALLY MARIE ELIZABETH SIVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10301 MAYO DR, BARLING, AR 72923-1660
(479) 494-5700
Mailing address
119 DARTMOUTH LN, FORT SMITH, AR 72908-8200
(479) 561-9583
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
A005843
AR
Other
Enumeration date
09/04/2018
Last updated
09/04/2018
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