Healthcare Provider Details

I. General information

NPI: 1881384949
Provider Name (Legal Business Name): HANNAH JANE BOAZ APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 W NEWMAN AVE
HARRISON AR
72601-5839
US

IV. Provider business mailing address

3605 W LEGACY LN
ROGERS AR
72758-8421
US

V. Phone/Fax

Practice location:
  • Phone: 479-318-2828
  • Fax:
Mailing address:
  • Phone: 479-263-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number224143
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: