Healthcare Provider Details

I. General information

NPI: 1013157064
Provider Name (Legal Business Name): ANITA K WHITE CRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 ALBERT PIKE RD STE H
HOT SPRINGS AR
71913-4090
US

IV. Provider business mailing address

102A FLINTROCK ST
HOT SPRINGS AR
71913-9864
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-8520
  • Fax: 501-623-8237
Mailing address:
  • Phone: 501-276-1075
  • Fax: 501-623-8237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2278P1005X
TaxonomyPulmonary Rehabilitation Certified Respiratory Therapist
License NumberRCP-1889
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: