Healthcare Provider Details

I. General information

NPI: 1194984336
Provider Name (Legal Business Name): STEPHEN ANDREW HEARN PT, DPT, ACNP, APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 RIVER RUN RD
EUREKA SPRINGS AR
72632-8883
US

IV. Provider business mailing address

30 RIVER RUN RD
EUREKA SPRINGS AR
72632-8883
US

V. Phone/Fax

Practice location:
  • Phone: 501-336-4035
  • Fax: 501-336-4035
Mailing address:
  • Phone: 501-336-4035
  • Fax: 501-336-4035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number675
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA004568
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: