Healthcare Provider Details

I. General information

NPI: 1053892182
Provider Name (Legal Business Name): SARA BUSES BROWN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 ROGERS AVE
FORT SMITH AR
72901-4227
US

IV. Provider business mailing address

410 DALLAS ST STE 4
TALIHINA OK
74571-2405
US

V. Phone/Fax

Practice location:
  • Phone: 479-226-8770
  • Fax:
Mailing address:
  • Phone: 346-848-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number225682
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1206756
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number85641
License Number StateNM
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number235194
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: