Individual
ANITA XAYAPHETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
396 MOUNT ZION RD, RUSSELLVILLE, AR 72802-1514
(479) 622-0633
Mailing address
396 MOUNT ZION RD, RUSSELLVILLE, AR 72802-1514
(479) 622-0633
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A005446
AR
Other
Enumeration date
01/08/2018
Last updated
01/08/2018
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