Healthcare Provider Details

I. General information

NPI: 1265350243
Provider Name (Legal Business Name): DORIAN GRAYSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 S BOWMAN RD
LITTLE ROCK AR
72211-4136
US

IV. Provider business mailing address

709 S PORTER ST
STUTTGART AR
72160-4717
US

V. Phone/Fax

Practice location:
  • Phone: 501-558-4100
  • Fax: 501-558-4101
Mailing address:
  • Phone: 501-558-4100
  • Fax: 501-558-4101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number238471
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: