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General NPI Number Information
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NPI Number | 1164626990
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Entity Type | Organization
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Legal Business Name | ARKANSAS CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 800 MARSHALL ST
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3510
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Country | US
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Telephone | 501-364-1759
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Fax |
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Provider Business Mailing Address
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Address Line | 5026 WHITNEY LN
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City | BENTON
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State | AR
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Zip | 72015-0900
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Country | US
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Telephone | 501-315-7935
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Fax |
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Authorized Official
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Title or Position | ADVANCED NURSE PRACTITIONER
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Name | MRS. JOY ANGELA CHILDRESS
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Credential | APN
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Telephone | 501-364-1759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | A01476
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License Number State | AR
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