Healthcare Provider Details

I. General information

NPI: 1316322787
Provider Name (Legal Business Name): ALISA DANIELLE RUFFNER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISA WHITFIELD

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1636 HIGDON FERRY RD
HOT SPRINGS AR
71913-6912
US

IV. Provider business mailing address

6031 CHARLEY PL
BENTON AR
72019-8937
US

V. Phone/Fax

Practice location:
  • Phone: 501-651-2000
  • Fax: 501-651-2394
Mailing address:
  • Phone: 501-651-2000
  • Fax: 501-651-2394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004449
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number084250
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberA004449
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: