Healthcare Provider Details

I. General information

NPI: 1306049812
Provider Name (Legal Business Name): LUANN RYALS JONES APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MARSHALL STREET SLOT 512
LITTLE ROCK AR
72202
US

IV. Provider business mailing address

800 MARSHALL STREET SLOT 512
LITTLE ROCK AR
72202-3591
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1244
  • Fax: 501-364-0445
Mailing address:
  • Phone: 501-364-1244
  • Fax: 501-364-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberA01393 ANP
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: