Healthcare Provider Details

I. General information

NPI: 1275424731
Provider Name (Legal Business Name): BRIDGETTE J POWELL MSN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 PRINCE ST
CONWAY AR
72034-8042
US

IV. Provider business mailing address

416 HIGHWAY 225 W
GREENBRIER AR
72058-9454
US

V. Phone/Fax

Practice location:
  • Phone: 501-932-0255
  • Fax: 501-932-0258
Mailing address:
  • Phone: 501-314-4655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number213748
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: