Healthcare Provider Details

I. General information

NPI: 1184010340
Provider Name (Legal Business Name): SANDRA L HOWARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1309 W MAIN ST
WALNUT RIDGE AR
72476-1430
US

IV. Provider business mailing address

PO BOX 839
WALNUT RIDGE AR
72476-0839
US

V. Phone/Fax

Practice location:
  • Phone: 870-886-3211
  • Fax: 870-886-3616
Mailing address:
  • Phone: 870-886-3211
  • Fax: 870-886-3616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA0004428
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberATP-000766
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: