Healthcare Provider Details

I. General information

NPI: 1326656513
Provider Name (Legal Business Name): HEATHER PORTERFIELD APRN, AGCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HEATHER BLUNDELL

II. Dates (important events)

Enumeration Date: 07/14/2020
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST # 556
LITTLE ROCK AR
72205-7101
US

IV. Provider business mailing address

4301 W MARKHAM ST # 783
LITTLE ROCK AR
72205-7101
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-6067
  • Fax: 501-526-7467
Mailing address:
  • Phone: 501-686-8000
  • Fax: 501-526-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number126246
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License Number126246
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: