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General NPI Number Information
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NPI Number | 1154203917
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Entity Type | Organization
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Legal Business Name | INNER LIGHT INTEGRATIVE HEALTH, PLLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1311 FORT ST STE J
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City | BARLING
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State | AR
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Zip | 72923-2045
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Country | US
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Telephone | 479-430-8261
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Fax | 800-420-2695
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Provider Business Mailing Address
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Address Line | 7609 HORAN DR
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City | FORT SMITH
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State | AR
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Zip | 72903-5109
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Country | US
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Telephone | 479-430-8261
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. SARAH ROSE ANDERSON
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Credential | APRN
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Telephone | 479-430-8261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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