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General NPI Number Information
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NPI Number | 1265154272
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Entity Type | Organization
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Legal Business Name | NATURAL STATE IVY
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 301 MAIN ST STE 202
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-4918
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Country | US
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Telephone | 501-621-2442
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Fax | 501-687-5234
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Provider Business Mailing Address
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Address Line | 301 MAIN ST STE 202
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-4918
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Country | US
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Telephone | 501-208-7037
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Fax |
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Authorized Official
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Title or Position | OWNER/NP
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Name | DARREL COLBY HAWLEY
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Credential | NP
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Telephone | 501-208-7037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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