Healthcare Provider Details

I. General information

NPI: 1679417240
Provider Name (Legal Business Name): CELSEY LITTLE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CELSEY MYERS

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9001 JENNY LIND RD STE 3
FORT SMITH AR
72908-8629
US

IV. Provider business mailing address

9001 JENNY LIND RD STE 3
FORT SMITH AR
72908-8629
US

V. Phone/Fax

Practice location:
  • Phone: 479-385-9001
  • Fax: 479-668-3699
Mailing address:
  • Phone: 479-385-9001
  • Fax: 479-668-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236791
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: