Healthcare Provider Details

I. General information

NPI: 1831630110
Provider Name (Legal Business Name): CHRISTEN HOPE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3343 SPRINGHILL DR STE 1035
NORTH LITTLE ROCK AR
72117-2930
US

IV. Provider business mailing address

11001 EXECUTIVE CENTER DR STE 200
LITTLE ROCK AR
72211-4393
US

V. Phone/Fax

Practice location:
  • Phone: 501-975-7676
  • Fax: 501-975-0653
Mailing address:
  • Phone: 501-975-7676
  • Fax: 501-975-0653

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number322538
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberE-16570
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: