Healthcare Provider Details

I. General information

NPI: 1689596660
Provider Name (Legal Business Name): MARCIA LYNN WIDEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 9TH ST
HOPE AR
71801-6707
US

IV. Provider business mailing address

165 HEMPSTEAD 1410
WASHINGTON AR
71862-9022
US

V. Phone/Fax

Practice location:
  • Phone: 870-722-2770
  • Fax:
Mailing address:
  • Phone: 870-703-0134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR21882
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: