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General NPI Number Information
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NPI Number | 1255767653
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Entity Type | Individual
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Provider Name | LISA CULP HELD PONTIOUS CNM, APRN
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Gender | Female
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 01/24/2025
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Provider Practice Location Address
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Address Line | 6119 MIDTOWN AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5313
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Country | US
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Telephone | 501-296-1800
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Fax | 501-296-1711
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST # 783
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-8000
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Fax | 501-526-5148
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 53-80752-112
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 2013034503
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | M002125
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License Number State | AR
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