Healthcare Provider Details

I. General information

NPI: 1316773559
Provider Name (Legal Business Name): FRONTLINE HEALTHCARE PROFESSIONALS, ARKANSAS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W CAPITOL AVE STE 1745
LITTLE ROCK AR
72201-3436
US

IV. Provider business mailing address

2513 MCCAIN BLVD STE #2, PMB #309
NORTH LITTLE ROCK AR
72116
US

V. Phone/Fax

Practice location:
  • Phone: 772-925-5492
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA JEFFERSON
Title or Position: CEO
Credential: LNHA
Phone: 501-416-5705