Individual
MISS SUSAN KATHRYN MCCLINTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
405 E COLLIN RAYE DR STE C, DE QUEEN, AR 71832-4107
(866) 282-0406
(866) 282-5926
Mailing address
405 E COLLIN RAYE DR STE C, DE QUEEN, AR 71832-4107
(866) 282-0406
(866) 282-5926
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
53-76306-031
KS
363LA2200X
Adult Health Nurse Practitioner
53-76306-031
KS
363LG0600X
Gerontology Nurse Practitioner
53-76306-031
KS
Other
Enumeration date
04/02/2014
Last updated
05/20/2019
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