Healthcare Provider Details

I. General information

NPI: 1710802541
Provider Name (Legal Business Name): SARA ELISABETH NUTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 S Q ST
FORT SMITH AR
72901-5334
US

IV. Provider business mailing address

2601 S Q ST
FORT SMITH AR
72901-5334
US

V. Phone/Fax

Practice location:
  • Phone: 479-783-1280
  • Fax: 479-785-1513
Mailing address:
  • Phone: 479-783-1280
  • Fax: 479-785-1513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR63655
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: