Healthcare Provider Details

I. General information

NPI: 1871466102
Provider Name (Legal Business Name): WHITNEY NICOLE TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 STATE HIGHWAY 77
MARION AR
72364-9053
US

IV. Provider business mailing address

1139 STATE HIGHWAY 77
MARION AR
72364-9053
US

V. Phone/Fax

Practice location:
  • Phone: 870-559-2480
  • Fax:
Mailing address:
  • Phone: 870-559-2480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number219971
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number219971
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: