Healthcare Provider Details

I. General information

NPI: 1891620894
Provider Name (Legal Business Name): FAITH EALY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 HUDSON BRANCH DR
AUSTIN AR
72007-9719
US

IV. Provider business mailing address

133 HUDSON BRANCH DR
AUSTIN AR
72007-9719
US

V. Phone/Fax

Practice location:
  • Phone: 501-786-3093
  • Fax:
Mailing address:
  • Phone: 501-786-3093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License NumberR096805
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: