Most Relevant Information
Provider Data
| NPI Number: | 1003355447 |
| Provider Name: | LEROY MAUPIN APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | A005035 |
Most Important Dates
| Enumeration Date: | 02/17/2017 |
| Last Updated: | 02/17/2017 |
Provider Practice Location
407 VIRGINIA DR
BATESVILLE
AR
725017329
Practice Location Phone/Fax
| Phone: | 8707934200 |
| Fax: | 8706981353 |
Provider Mailing Location
407 VIRGINIA DR
BATESVILLE
AR
725017329
Provider Mailing Phone/Fax
| Phone: | 8707934200 |
| Fax: | 8706981353 |