Healthcare Provider Details

I. General information

NPI: 1750285524
Provider Name (Legal Business Name): LILLYANNE MCCOOL LILLYANNE MCCOOL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1810 OZARKA COLLEGE DR
MOUNTAIN VIEW AR
72560-6455
US

IV. Provider business mailing address

725 HERST RD
MOUNTAIN VIEW AR
72560-5011
US

V. Phone/Fax

Practice location:
  • Phone: 870-269-2110
  • Fax: 870-269-2923
Mailing address:
  • Phone: 870-269-2110
  • Fax: 870-269-2923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number237456
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: