Healthcare Provider Details

I. General information

NPI: 1790716314
Provider Name (Legal Business Name): BILLY H NOEL APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/21/2023
Certification Date: 07/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9207HWY 71 SUITE 8&9
FORT SMITH AR
72916-4683
US

IV. Provider business mailing address

9207 HIGHWAY 71 S STE 9
FORT SMITH AR
72916-9389
US

V. Phone/Fax

Practice location:
  • Phone: 479-668-4778
  • Fax: 479-675-1391
Mailing address:
  • Phone: 479-668-4778
  • Fax: 479-675-1391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberA01824
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: