Healthcare Provider Details

I. General information

NPI: 1740665850
Provider Name (Legal Business Name): DEANNA JAMES RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEANNA HILDEBRAND

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4200 N RODNEY PARHAM RD SUITE 202
LITTLE ROCK AR
72212-2461
US

IV. Provider business mailing address

4200 N RODNEY PARHAM RD SUITE 202
LITTLE ROCK AR
72212-2461
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-4323
  • Fax: 501-227-4149
Mailing address:
  • Phone: 501-227-4323
  • Fax: 501-227-4149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberP001288
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR038107
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: