Doctor Name: | CHRISTA BARTLETT |
NPI Number: | 1770954927 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | P-T1546 |
Business Practice Address: | 1652 State Highway 22 W Dardanelle, AR - 728342909 |
Business Phone Number: | 4792298000 |
Business Fax Number: | 4794773925 |
Mailing Address: | Po Box 2, DELAWARE |
State: | AR |
Postal Code: | 728350002 |
Phone Number: | 4792298000 |
Fax Number: | 4794773925 |
NPI Enumeration Date: | 10/14/2015 |
NPI Last Update Date: | 10/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | P-T1546 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |