Healthcare Provider Details

I. General information

NPI: 1326986787
Provider Name (Legal Business Name): DEANNA WHITTLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 TEXAS AVE
NORTH LITTLE ROCK AR
72118-2844
US

IV. Provider business mailing address

513 LIBBY LN
NORTH LITTLE ROCK AR
72118-3130
US

V. Phone/Fax

Practice location:
  • Phone: 501-235-0909
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: