Healthcare Provider Details

I. General information

NPI: 1508770884
Provider Name (Legal Business Name): MARNEICA R CLAY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 GEYER SPRINGS RD
LITTLE ROCK AR
72209-4949
US

IV. Provider business mailing address

8501 GEYER SPRINGS RD
LITTLE ROCK AR
72209-4949
US

V. Phone/Fax

Practice location:
  • Phone: 501-650-4416
  • Fax:
Mailing address:
  • Phone: 501-650-4416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number48568
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: