Healthcare Provider Details

I. General information

NPI: 1700079811
Provider Name (Legal Business Name): CATHERINE ELIZABETH FLANNIGAN RNFA, APRN-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 ROGERS AVE STE 200
FORT SMITH AR
72903-4022
US

IV. Provider business mailing address

PO BOX 776084
CHICAGO IL
60677-6084
US

V. Phone/Fax

Practice location:
  • Phone: 479-314-7490
  • Fax: 479-314-7494
Mailing address:
  • Phone: 479-314-7490
  • Fax: 479-314-7494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number234379
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number630803
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number202059
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1028600
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: