Healthcare Provider Details

I. General information

NPI: 1588334361
Provider Name (Legal Business Name): PARKER JOINER PEDIATRIC APRN SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/23/2021
Certification Date: 09/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22461 INTERSTATE 30 STE 402
BRYANT AR
72022-2383
US

IV. Provider business mailing address

210 S LAUREL ST
BRYANT AR
72022-4022
US

V. Phone/Fax

Practice location:
  • Phone: 501-481-8800
  • Fax: 501-500-6382
Mailing address:
  • Phone: 501-590-0934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. PRISCILLA PARKER JOINER
Title or Position: APRN
Credential: MSNC, APRN, CPNP-PC
Phone: 501-590-0934