Healthcare Provider Details

I. General information

NPI: 1487589230
Provider Name (Legal Business Name): LEGACY HEALTH AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 FALLS BLVD S
WYNNE AR
72396-3501
US

IV. Provider business mailing address

421 FALLS BLVD S
WYNNE AR
72396-3501
US

V. Phone/Fax

Practice location:
  • Phone: 870-587-0900
  • Fax: 870-587-0903
Mailing address:
  • Phone: 870-587-0900
  • Fax: 870-587-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHERRY MCCRARY
Title or Position: APRN/OWNER
Credential: APRN
Phone: 870-587-0900