Healthcare Provider Details

I. General information

NPI: 1386651594
Provider Name (Legal Business Name): MARGARET ANN ANDERSON APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 FORT ROOTS DR
NORTH LITTLE ROCK AR
72114-1709
US

IV. Provider business mailing address

9127 SPRINGHILL FARMS DR
ALEXANDER AR
72002-9557
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-3136
  • Fax:
Mailing address:
  • Phone: 501-316-0359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberS01047
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: