NPI 1104426261 · live from the CMS NPI Registry
Mandy Clark, APRN
Nurse Practitioner, Pediatrics in Springdale, AR. National Provider Identifier 1104426261, active.
NPI record
| NPI | 1104426261 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 614 E Emma Ave Ste 300, Springdale, AR 72764 |
| Practice phone | 479-751-7417 |
| Enumerated | October 28, 2020 |
| Last updated | December 6, 2023 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | A006213 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.