Healthcare Provider Details

I. General information

NPI: 1033692942
Provider Name (Legal Business Name): CHELSEA POINDEXTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5532 JFK BLVD
NORTH LITTLE ROCK AR
72116-6708
US

IV. Provider business mailing address

8503 MERRIWOOD CT
SHERWOOD AR
72120-5334
US

V. Phone/Fax

Practice location:
  • Phone: 501-588-3211
  • Fax:
Mailing address:
  • Phone: 870-451-2192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-A1869
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: