Healthcare Provider Details

I. General information

NPI: 1114145893
Provider Name (Legal Business Name): DANA R. REED APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 S WHITEHEAD DR
DE WITT AR
72042-2994
US

IV. Provider business mailing address

103 STONEBROOK
HELENA AR
72342-2205
US

V. Phone/Fax

Practice location:
  • Phone: 870-946-3637
  • Fax: 870-946-4410
Mailing address:
  • Phone: 870-572-4077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01863
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: