Healthcare Provider Details

I. General information

NPI: 1316861032
Provider Name (Legal Business Name): BRITTNEY HUMPHREY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 MABELVALE PIKE
MABELVALE AR
72103-1667
US

IV. Provider business mailing address

8506 OXFORD VALLEY DR
MABELVALE AR
72103-2311
US

V. Phone/Fax

Practice location:
  • Phone: 501-551-6609
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number124972
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: