Individual
CHERRIE PHOUTHAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 ROGERS AVE, FORT SMITH, AR 72903-4100
(479) 314-6992
Mailing address
7001 MILLENNIUM DR, FORT SMITH, AR 72916-8825
(479) 461-5590
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A004626
AR
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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