Healthcare Provider Details

I. General information

NPI: 1245165034
Provider Name (Legal Business Name): ANGIE HUNTON MNSC, RNC OB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13984 GREASY VALLEY RD
PRAIRIE GROVE AR
72753-9395
US

IV. Provider business mailing address

13984 GREASY VALLEY RD
PRAIRIE GROVE AR
72753-9395
US

V. Phone/Fax

Practice location:
  • Phone: 479-713-5173
  • Fax:
Mailing address:
  • Phone: 479-713-5173
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberR037178
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: