=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245930874
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FELICIA NICOLE NOWLIN MSN, APRN, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/02/2023
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1040 SANTA FE TRL
-----------------------------------------------------
City | BAUXITE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72011-5001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-820-8167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6834 CANTRELL RD # 2427
-----------------------------------------------------
City | LITTLE ROCK
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72207-4135
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-574-2964
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 223589
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------