Healthcare Provider Details

I. General information

NPI: 1982739496
Provider Name (Legal Business Name): MARKED TREE SCHOOLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 SAINT FRANCIS ST
MARKED TREE AR
72365-2241
US

IV. Provider business mailing address

406 SAINT FRANCIS ST
MARKED TREE AR
72365-2241
US

V. Phone/Fax

Practice location:
  • Phone: 870-358-2212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER HALL
Title or Position: SPECIAL EDUCATION SUPERVISOR
Credential:
Phone: 870-358-2913