Healthcare Provider Details

I. General information

NPI: 1053230466
Provider Name (Legal Business Name): ASHLEY NICOLE HEAD-CONDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 MAIN ST
PLEASANT PLAINS AR
72568-9529
US

IV. Provider business mailing address

741 MAIN ST
PLEASANT PLAINS AR
72568-9529
US

V. Phone/Fax

Practice location:
  • Phone: 501-530-0378
  • Fax:
Mailing address:
  • Phone: 501-345-2610
  • Fax: 501-345-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR095620
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: