Healthcare Provider Details

I. General information

NPI: 1790933513
Provider Name (Legal Business Name): CHARL Y. BUXTON PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHARL Y HOLMES

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WELLNESS WAY
HOT SPRINGS AR
71913-6478
US

IV. Provider business mailing address

10025 W MARKHAM ST STE 210
LITTLE ROCK AR
72205-2178
US

V. Phone/Fax

Practice location:
  • Phone: 501-620-5100
  • Fax: 501-620-5325
Mailing address:
  • Phone: 501-663-5473
  • Fax: 501-661-1812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA03582
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number601018T
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number601018
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: