Healthcare Provider Details

I. General information

NPI: 1467763110
Provider Name (Legal Business Name): STEPHANIE ANN RAGSDALE ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 11/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4517 PARK AVE
HOT SPRINGS AR
71901-9476
US

IV. Provider business mailing address

120 ADCOCK RD A FIRST CARE WALK-IN CLINIC
HOT SPRINGS NATIONAL PARK AR
71913-7958
US

V. Phone/Fax

Practice location:
  • Phone: 501-623-7900
  • Fax: 501-623-7337
Mailing address:
  • Phone: 501-651-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA03369
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: