Individual
URSULA DESHA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
900 N 7TH ST, WEST MEMPHIS, AR 72301-2001
(870) 735-3842
Mailing address
900 N 7TH ST, WEST MEMPHIS, AR 72301-2001
(870) 735-3842
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R081506
AR
363LF0000X
Family Nurse Practitioner
22291
TN
363LF0000X
Family Nurse Practitioner
Primary
A005049
AR
Other
Enumeration date
04/05/2017
Last updated
10/13/2023
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