Healthcare Provider Details

I. General information

NPI: 1700573789
Provider Name (Legal Business Name): MAYA SIMONE HOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20200 SONORA RD
SPRINGDALE AR
72764-8255
US

IV. Provider business mailing address

20200 SONORA RD
SPRINGDALE AR
72764-8255
US

V. Phone/Fax

Practice location:
  • Phone: 479-750-8820
  • Fax:
Mailing address:
  • Phone: 479-750-8820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number2125019
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: