Healthcare Provider Details

I. General information

NPI: 1982953097
Provider Name (Legal Business Name): TONYA ALLENE HULVEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2012
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 W MAPLE AVE
SPRINGDALE AR
72764
US

IV. Provider business mailing address

614 E EMMA AVE STE 300
SPRINGDALE AR
72764-4469
US

V. Phone/Fax

Practice location:
  • Phone: 479-757-5400
  • Fax: 479-750-4672
Mailing address:
  • Phone: 479-757-5400
  • Fax: 479-750-4672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR53979
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA03678
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: