Healthcare Provider Details

I. General information

NPI: 1093098279
Provider Name (Legal Business Name): ANNE FRENCH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 09/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 ELM STREET
TUCKERMAN AR
72473
US

IV. Provider business mailing address

PO BOX 1298
TUCKERMAN AR
72473-1298
US

V. Phone/Fax

Practice location:
  • Phone: 870-349-1313
  • Fax: 870-349-1311
Mailing address:
  • Phone: 870-349-1313
  • Fax: 870-349-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License NumberR64336
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: