Individual
MASHELIA BROADWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 W 7TH ST, LITTLE ROCK, AR 72205-5446
(501) 257-1000
Mailing address
1 APPLE BERRY CV, LITTLE ROCK, AR 72206-6999
(501) 490-1779
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A004180
AR
363LG0600X
Gerontology Nurse Practitioner
A004180
AR
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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