Individual
CONNIE ANN WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 CENTRAL AVE, SEARCY, AR 72143-7328
(501) 305-3305
(501) 279-0760
Mailing address
1 CHILDRENS WAY, SLOT 900, LITTLE ROCK, AR 72202
(501) 364-3620
(501) 364-3994
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R44515
AR
Other
Enumeration date
05/21/2009
Last updated
05/21/2009
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