Healthcare Provider Details

I. General information

NPI: 1215871611
Provider Name (Legal Business Name): BROOKE OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4608 WESTCHESTER DR
LITTLE ROCK AR
72223-4314
US

IV. Provider business mailing address

4608 WESTCHESTER DR
LITTLE ROCK AR
72223-4314
US

V. Phone/Fax

Practice location:
  • Phone: 870-307-1266
  • Fax:
Mailing address:
  • Phone: 870-307-1266
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPD10825
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: