Healthcare Provider Details

I. General information

NPI: 1740575075
Provider Name (Legal Business Name): DERAINEY R. SMITH FNP, DNP, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

437 HIGHWAY 62 EAST
YELLVILLE AR
72687-4603
US

IV. Provider business mailing address

437 HIGHWAY 62 EAST
YELLVILLE AR
72687-2580
US

V. Phone/Fax

Practice location:
  • Phone: 870-449-9355
  • Fax: 870-423-7178
Mailing address:
  • Phone: 870-449-9355
  • Fax: 417-829-4316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberA003560
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA003560
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: