Provider Demographics
NPI:1427000645
Name:SAMMER, BETTY JO (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:JO
Last Name:SAMMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-1847
Mailing Address - Country:US
Mailing Address - Phone:479-855-6164
Mailing Address - Fax:479-855-2831
Practice Address - Street 1:600 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-1847
Practice Address - Country:US
Practice Address - Phone:479-855-6164
Practice Address - Fax:479-855-2831
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03473363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner