Pham-Russell, Marie

Pham-Russell, Marie is an individual health care provider with primary practice located at 3202 N 6Th St , Fort Smith AR 72904-4164. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family Health, which is considered as her primary health care specialty. Pham-Russell, Marie can be contacted via phone (479) 783-3900.

Contact Information

Primary practice address
3202 N 6Th St Fort Smith AR 72904-4164
Phone: (479) 783-3900
Fax: (479) 783-3905
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family Health 364SF0001X A001764 Arkansas

Profile Details

NPI number 1376538090
LBN Legal business name Pham-Russell, Marie
Credentials DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Mar 20th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376538090 NPPES
Arkansas MEDICAID 165901758

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