Most Relevant Information
Provider Data
| NPI Number: | 1003465618 |
| Provider Name: | COREY WAYNE DORMAN APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 121555 |
Most Important Dates
| Enumeration Date: | 09/06/2019 |
| Last Updated: | 12/21/2021 |
Provider Practice Location
2069 W. CENTER ST.
BEEBE
AR
720126873
Practice Location Phone/Fax
| Phone: | 5016289212 |
| Fax: | 5012329501 |
Provider Mailing Location
2069 W. CENTER ST.
BEEBE
AR
720126873
Provider Mailing Phone/Fax
| Phone: | 5016289212 |
| Fax: |