NPI 1386205359

Lasonjia Denise Blackmon

Practitioner Driver Little Rock, AR

Practice location

Address: 5202 Mulberry Pl, Little Rock, AR 72206-4913
Phone: (501) 772-6073

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1386205359
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Jun 2019
Record last updated: 21 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.