Healthcare Provider Details
I. General information
NPI: 1376057703
Provider Name (Legal Business Name): NANCY HORNSTEIN PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/21/2017
Last Update Date: 11/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1401 MALVERN AVE
HOT SPRINGS AR
71901-6327
US
IV. Provider business mailing address
423 TRIVISTA RIGHT ST
HOT SPRINGS AR
71901-7465
US
V. Phone/Fax
- Phone: 501-538-2762
- Fax: 501-701-4312
- Phone: 501-538-2762
- Fax: 501-701-4312
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | E-3071 |
| License Number State | AR |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0804X |
| Taxonomy | Child & Adolescent Psychiatry Physician |
| License Number | E3071 |
| License Number State | AR |
VIII. Authorized Official
Name: DR.
NANCY
L
HORNSTEIN
Title or Position: PRESIDENT
Credential: MD
Phone: 501-538-2761