Healthcare Provider Details

I. General information

NPI: 1568357234
Provider Name (Legal Business Name): CANDACE M HULETT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6321
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR
LITTLE ROCK AR
72211-4348
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-2093
  • Fax: 501-202-6316
Mailing address:
  • Phone: 501-202-2093
  • Fax: 501-202-6316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number233699
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: