Healthcare Provider Details

I. General information

NPI: 1770472474
Provider Name (Legal Business Name): BONNIE DAVIS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9501 BAPTIST HEALTH DR STE 600
LITTLE ROCK AR
72205-6231
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-227-7596
  • Fax: 501-227-7787
Mailing address:
  • Phone: 501-812-7800
  • Fax: 501-812-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number215666
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: