Healthcare Provider Details

I. General information

NPI: 1821889619
Provider Name (Legal Business Name): ERAS WOMEN'S HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2025
Last Update Date: 05/13/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4018 E CASTON DR
FAYETTEVILLE AR
72701-3084
US

IV. Provider business mailing address

4018 E CASTON DR
FAYETTEVILLE AR
72701-3084
US

V. Phone/Fax

Practice location:
  • Phone: 901-497-2562
  • Fax:
Mailing address:
  • Phone: 901-497-2562
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: NATALIE SHEW
Title or Position: MANAGER/CEO
Credential:
Phone: 901-497-2562