Healthcare Provider Details

I. General information

NPI: 1336060516
Provider Name (Legal Business Name): STACY DRISKILL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 W CENTER ST
BEEBE AR
72012-3103
US

IV. Provider business mailing address

1201 W CENTER ST
BEEBE AR
72012-3103
US

V. Phone/Fax

Practice location:
  • Phone: 501-882-5463
  • Fax: 501-726-4433
Mailing address:
  • Phone: 501-882-5463
  • Fax: 501-726-4433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR54433
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: