Healthcare Provider Details

I. General information

NPI: 1417154170
Provider Name (Legal Business Name): CHRISTI M SPROLES APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MARSHALL STREET
LITTLE ROCK AR
72202-3591
US

IV. Provider business mailing address

13605 HANSFIELD CIR
NORTH LITTLE ROCK AR
72117-5366
US

V. Phone/Fax

Practice location:
  • Phone: 501-364-1244
  • Fax:
Mailing address:
  • Phone: 501-379-8064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberA03011
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberAP04443
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: