Healthcare Provider Details

I. General information

NPI: 1023155181
Provider Name (Legal Business Name): TONYA ANN LABAT LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 HWY 65 S. SUITE 202
CLINTON AR
72031
US

IV. Provider business mailing address

2487 STRACNER RD
CLEVELAND AR
72030-8005
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-4584
  • Fax: 501-745-5921
Mailing address:
  • Phone: 501-592-3794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberL39897
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: