Healthcare Provider Details

I. General information

NPI: 1215478375
Provider Name (Legal Business Name): SHERITA LEE PMHNP-BC, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2017
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 FENDLEY DR
NORTH LITTLE ROCK AR
72114-1806
US

IV. Provider business mailing address

2007 FENDLEY DR
NORTH LITTLE ROCK AR
72114-1806
US

V. Phone/Fax

Practice location:
  • Phone: 501-246-3261
  • Fax: 501-916-2776
Mailing address:
  • Phone: 501-246-3261
  • Fax: 501-916-2776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberA005081
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA005081
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA005081
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: