Colburn, Dusty Marie
Colburn, Dusty Marie is an individual health care provider with primary practice located at 4900 Kelley Hwy , Fort Smith AR 72904-5000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Colburn, Dusty Marie can be contacted via phone (479) 785-5700.Contact Information
Primary practice address
4900 Kelley Hwy
Fort Smith AR 72904-5000
Phone: (479) 785-5700
Fax: (479) 785-5708
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | A005776 | Arkansas |
Profile Details
| NPI number | 1730665449 |
|---|---|
| LBN Legal business name | Colburn, Dusty Marie |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2018 |
| Last updated | May 1st, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730665449 | NPPES |
| Arkansas | MEDICAID | 137012001 |
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