Healthcare Provider Details

I. General information

NPI: 1366213613
Provider Name (Legal Business Name): ANNA K AUMAN MURRAY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13714 PIN OAK RD
FAYETTEVILLE AR
72704-8133
US

IV. Provider business mailing address

13714 PIN OAK RD
FAYETTEVILLE AR
72704-8133
US

V. Phone/Fax

Practice location:
  • Phone: 870-841-0274
  • Fax:
Mailing address:
  • Phone: 870-841-0274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: