Healthcare Provider Details

I. General information

NPI: 1831348291
Provider Name (Legal Business Name): AMANDA J RYALS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMANDA J BYERS APRN-CNP

II. Dates (important events)

Enumeration Date: 09/10/2008
Last Update Date: 09/12/2023
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 MCCAIN BLVD STE 200
NORTH LITTLE ROCK AR
72116-7612
US

IV. Provider business mailing address

2504 MCCAIN BLVD STE 200
NORTH LITTLE ROCK AR
72116-7612
US

V. Phone/Fax

Practice location:
  • Phone: 501-781-2230
  • Fax: 833-226-0134
Mailing address:
  • Phone: 501-781-2230
  • Fax: 833-226-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA03183
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR71480
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: