Healthcare Provider Details

I. General information

NPI: 1689598278
Provider Name (Legal Business Name): DOVIE BAXTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N HICKORY ST
BALD KNOB AR
72010-3024
US

IV. Provider business mailing address

901 N HICKORY ST
BALD KNOB AR
72010-3164
US

V. Phone/Fax

Practice location:
  • Phone: 501-724-5652
  • Fax: 501-724-2062
Mailing address:
  • Phone: 501-724-5652
  • Fax: 501-724-2062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR052767
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: