Healthcare Provider Details

I. General information

NPI: 1083500797
Provider Name (Legal Business Name): ASHTON S FERRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 SCHOOL AVE STE A
WEST FORK AR
72774-3124
US

IV. Provider business mailing address

245 SCHOOL AVE STE A
WEST FORK AR
72774-3124
US

V. Phone/Fax

Practice location:
  • Phone: 479-839-4351
  • Fax:
Mailing address:
  • Phone: 479-839-4351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number124724
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: