Healthcare Provider Details

I. General information

NPI: 1194660274
Provider Name (Legal Business Name): EMBER PRIME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 W ARCH AVE
SEARCY AR
72143-5206
US

IV. Provider business mailing address

602 W ARCH AVE
SEARCY AR
72143-5206
US

V. Phone/Fax

Practice location:
  • Phone: 501-388-9811
  • Fax:
Mailing address:
  • Phone: 501-388-9811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AUDREY RACHEL ALEXANDER
Title or Position: APRN
Credential: MSN, APRN
Phone: 501-388-9811