Healthcare Provider Details

I. General information

NPI: 1992632863
Provider Name (Legal Business Name): PARIS HATCHETT FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 WINTER LN
DOVER AR
72837-7587
US

IV. Provider business mailing address

233 WINTER LN
DOVER AR
72837-7587
US

V. Phone/Fax

Practice location:
  • Phone: 479-518-2173
  • Fax:
Mailing address:
  • Phone: 479-518-2173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236990
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: