Healthcare Provider Details

I. General information

NPI: 1811362510
Provider Name (Legal Business Name): CIARA FRYAR MSN, APRN, NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2015
Last Update Date: 06/16/2022
Certification Date: 06/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 BAPTIST HEALTH DR
LITTLE ROCK AR
72205-6321
US

IV. Provider business mailing address

2420 LITTLE CREEK DR
CONWAY AR
72032-8921
US

V. Phone/Fax

Practice location:
  • Phone: 501-202-2077
  • Fax:
Mailing address:
  • Phone: 501-247-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberA004570
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: