Healthcare Provider Details
I. General information
NPI: 1508533050
Provider Name (Legal Business Name): APRIL ANN NUTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/24/2021
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
104 W STATE ST
CARAWAY AR
72419-8553
US
IV. Provider business mailing address
4196 HIGHWAY 62 412 STE A
HARDY AR
72542-8002
US
V. Phone/Fax
- Phone: 870-565-9205
- Fax: 870-895-2164
- Phone: 870-856-1202
- Fax: 870-856-2107
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 217240 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: