Healthcare Provider Details

I. General information

NPI: 1689512287
Provider Name (Legal Business Name): MEGAN MISENHEIMER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR STE 1200
LITTLE ROCK AR
72205-6334
US

IV. Provider business mailing address

16400 COLONEL GLENN RD
LITTLE ROCK AR
72210-1611
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-4131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number122162
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: