Individual
MS. MARY LOUISE BURR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
105 SPRING PARK DR, MOUNTAIN HOME, AR 72653-2386
(870) 424-0053
Mailing address
105 SPRING PARK DR, MOUNTAIN HOME, AR 72653-2386
(870) 424-0053
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A001859
AR
363L00000X
Nurse Practitioner
Primary
AO1859
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171117758
—
AR
05
—
1851484992
—
AR
Enumeration date
10/02/2006
Last updated
12/14/2023
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