Healthcare Provider Details

I. General information

NPI: 1952299026
Provider Name (Legal Business Name): YINYAN WU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 W MARKHAM ST BLDG II
LITTLE ROCK AR
72205-7199
US

IV. Provider business mailing address

4301 W MARKHAM ST BLDG II
LITTLE ROCK AR
72205-7199
US

V. Phone/Fax

Practice location:
  • Phone: 501-526-7858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number235374
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR101955
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: