Healthcare Provider Details

I. General information

NPI: 1821728171
Provider Name (Legal Business Name): ROSLYN WHITE-JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 W MARKHAM ST
LITTLE ROCK AR
72205-3328
US

IV. Provider business mailing address

5720 W MARKHAM ST
LITTLE ROCK AR
72205-3328
US

V. Phone/Fax

Practice location:
  • Phone: 501-664-6200
  • Fax:
Mailing address:
  • Phone: 501-664-6200
  • Fax: 501-664-6832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: