Healthcare Provider Details

I. General information

NPI: 1104603331
Provider Name (Legal Business Name): LAUREN DONNELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

2345 APPLE BLOSSOM LN
CONWAY AR
72034-8459
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-5530
  • Fax:
Mailing address:
  • Phone: 731-501-6419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number47207
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: