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General NPI Number Information
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NPI Number | 1003706722
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Entity Type | Individual
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Provider Name | CAITLIN CHEYENNE FENTON QBHP
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Gender | Female
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Dates
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Enumeration Date | 07/04/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 716 S PINE ST
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City | HARRISON
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State | AR
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Zip | 72601-5830
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Country | US
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Telephone | 870-204-6016
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Fax | 870-782-2914
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Provider Business Mailing Address
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Address Line | PO BOX 1131
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City | HARRISON
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State | AR
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Zip | 72602-1131
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Country | US
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Telephone | 870-204-6016
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Fax | 870-782-2914
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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