Healthcare Provider Details

I. General information

NPI: 1972427821
Provider Name (Legal Business Name): ASHLEY DENISE JOHNSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 JFK BLVD
NORTH LITTLE ROCK AR
72116-7311
US

IV. Provider business mailing address

407 N 4TH ST
CABOT AR
72023-2565
US

V. Phone/Fax

Practice location:
  • Phone: 501-747-2080
  • Fax:
Mailing address:
  • Phone: 501-298-7145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number238969
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: