Individual
MRS. RETHA S DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1200 MCLAIN STREET, NEWPORT, AR 72112
(870) 523-5272
(870) 523-4292
Mailing address
1200 MCLAIN STREET, NEWPORT, AR 72112
(870) 523-5272
(870) 523-4292
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01291
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500000784
RAILROAD MEDICARE
AR
Enumeration date
05/26/2006
Last updated
02/24/2012
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