Healthcare Provider Details

I. General information

NPI: 1740116342
Provider Name (Legal Business Name): PEYTYN DANIELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E WALNUT ST
GURDON AR
71743-1256
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 870-353-2800
  • Fax: 870-353-2801
Mailing address:
  • Phone: 870-353-2800
  • Fax: 870-353-2801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number120317
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: