Healthcare Provider Details

I. General information

NPI: 1932539418
Provider Name (Legal Business Name): ANGELA SHAWN METCALF MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2013
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4747 DUSTY LAKE DR STE G1
PINE BLUFF AR
71603-9056
US

IV. Provider business mailing address

PO BOX 497
AUGUSTA AR
72006-0497
US

V. Phone/Fax

Practice location:
  • Phone: 870-641-2991
  • Fax: 870-642-2992
Mailing address:
  • Phone: 870-347-2534
  • Fax: 870-301-2092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA006087
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: