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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730665449 NPPES
Arkansas MEDICAID 137012001

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