Healthcare Provider Details

I. General information

NPI: 1679499081
Provider Name (Legal Business Name): RANDALYN WARD APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 W HUNTINGTON AVE STE B
JONESBORO AR
72401-2714
US

IV. Provider business mailing address

17336 NAIL CREEK RD
POTEAU OK
74953-7508
US

V. Phone/Fax

Practice location:
  • Phone: 870-273-2799
  • Fax:
Mailing address:
  • Phone: 918-721-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number238254
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: