Healthcare Provider Details

I. General information

NPI: 1841112075
Provider Name (Legal Business Name): PAMELA ARCHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 E 11TH ST
DANVILLE AR
72833-9608
US

IV. Provider business mailing address

3452 IVY LN
DANVILLE AR
72833-6194
US

V. Phone/Fax

Practice location:
  • Phone: 479-227-0936
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR045067
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: