Healthcare Provider Details

I. General information

NPI: 1538331012
Provider Name (Legal Business Name): DONNA HARRY HARTFIELD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA HARRY CAMPBELL

II. Dates (important events)

Enumeration Date: 03/25/2008
Last Update Date: 12/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 REALTOR AVE
TEXARKANA AR
71854-1020
US

IV. Provider business mailing address

910 REALTOR AVE
TEXARKANA AR
71854-1020
US

V. Phone/Fax

Practice location:
  • Phone: 870-779-2723
  • Fax: 870-216-2583
Mailing address:
  • Phone: 870-779-2723
  • Fax: 870-216-2583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number793103
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: