Individual
TAMMY GULLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 PINE ST, ARKADELPHIA, AR 71923-4335
(870) 245-2210
Mailing address
2410 PINE ST, ARKADELPHIA, AR 71923-4335
(870) 245-2210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R74405
AR
Other
Enumeration date
09/18/2009
Last updated
09/18/2009
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