Healthcare Provider Details

I. General information

NPI: 1679198287
Provider Name (Legal Business Name): MARILYN ANNE JOHNSON-MCFARLAND APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARILYN ANNE JOHNSON APRN

II. Dates (important events)

Enumeration Date: 06/09/2020
Last Update Date: 06/15/2020
Certification Date: 06/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SAINT VINCENT CIR STE 440
LITTLE ROCK AR
72205-5492
US

IV. Provider business mailing address

22 CHENAL CIR
LITTLE ROCK AR
72223-9566
US

V. Phone/Fax

Practice location:
  • Phone: 501-666-4294
  • Fax: 501-666-8538
Mailing address:
  • Phone: 501-680-8166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number124522
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberM000113
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: