Healthcare Provider Details

I. General information

NPI: 1306760772
Provider Name (Legal Business Name): ANNA SANDERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 GREYHOUND DR
MARMADUKE AR
72443-9686
US

IV. Provider business mailing address

2082 GREENE 422 RD
MARMADUKE AR
72443
US

V. Phone/Fax

Practice location:
  • Phone: 870-597-2723
  • Fax:
Mailing address:
  • Phone: 870-597-2723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR104525
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: