Healthcare Provider Details
I. General information
NPI: 1053606145
Provider Name (Legal Business Name): EMILY LINDSAY STAGGS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2011
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 DALLAS ST
FORT SMITH AR
72903-5690
US
IV. Provider business mailing address
7900 DALLAS ST
FORT SMITH AR
72903-5690
US
V. Phone/Fax
- Phone: 479-242-6647
- Fax: 479-250-0505
- Phone: 479-242-6647
- Fax: 479-250-0505
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | TAP002568 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | A003988 |
| License Number State | AR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: