Healthcare Provider Details

I. General information

NPI: 1982538526
Provider Name (Legal Business Name): HEATHER ANN DAVIS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 W MCRAE AVE
SEARCY AR
72143-3638
US

IV. Provider business mailing address

609 W MCRAE AVE
SEARCY AR
72143-3638
US

V. Phone/Fax

Practice location:
  • Phone: 501-268-3936
  • Fax: 501-278-2283
Mailing address:
  • Phone: 501-268-3936
  • Fax: 501-278-2283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberL044498
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: