Healthcare Provider Details

I. General information

NPI: 1386180453
Provider Name (Legal Business Name): LAUREN LEOPARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN COOK CNP

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

691 PUMPKIN HILL RD
RISON AR
71665-8729
US

IV. Provider business mailing address

691 PUMPKIN HILL RD
RISON AR
71665-8729
US

V. Phone/Fax

Practice location:
  • Phone: 870-718-1249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004995
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: