Healthcare Provider Details

I. General information

NPI: 1457716029
Provider Name (Legal Business Name): CHASTA MANDY BARBEE-LUMPKIN CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 STATE HWY 110 W
HEBER SPRINGS AR
72543
US

IV. Provider business mailing address

110 TIMBER RIDGE RD
DRASCO AR
72530-9414
US

V. Phone/Fax

Practice location:
  • Phone: 501-362-0048
  • Fax: 501-362-8815
Mailing address:
  • Phone: 501-628-1096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberA004563
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: