Healthcare Provider Details

I. General information

NPI: 1518154699
Provider Name (Legal Business Name): ELIZABETH MCKELVEY PEELER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2007
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MARSHALL ST SLOT 512
LITTLE ROCK AR
72202
US

IV. Provider business mailing address

800 MARSHALL ST SLOT 512
LITTLE ROCK AR
72202
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 Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberA03041 ANP
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: