Healthcare Provider Details

I. General information

NPI: 1780403048
Provider Name (Legal Business Name): DREW ELISABETH HAMPTON APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2024
Last Update Date: 10/04/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ROLLER WEIGHT LOSS AND ADVANCED SURGERY 1695 E. RAINFOREST RD.
FAYETTEVILLE AR
72703
US

IV. Provider business mailing address

5804 W POISON SPRINGS DR
FAYETTEVILLE AR
72704-5028
US

V. Phone/Fax

Practice location:
  • Phone: 479-445-6460
  • Fax: 479-445-6719
Mailing address:
  • Phone: 479-403-8136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number216512
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: