Healthcare Provider Details

I. General information

NPI: 1598737249
Provider Name (Legal Business Name): BEVERLY KAY CARAWAY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2006
Last Update Date: 09/27/2021
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 HARRISON ST
BATESVILLE AR
72501-7417
US

IV. Provider business mailing address

2230 HARRISON ST
BATESVILLE AR
72501-7417
US

V. Phone/Fax

Practice location:
  • Phone: 870-698-2100
  • Fax: 870-698-0109
Mailing address:
  • Phone: 870-698-2100
  • Fax: 870-698-0109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA01906
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: