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General NPI Number Information
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NPI Number | 1487472866
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Entity Type | Organization
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Legal Business Name | MYHEALTH VILLAGE, PLLC
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 930 WINGATE ST STE C2
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City | CONWAY
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State | AR
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Zip | 72034-4837
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Country | US
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Telephone | 501-358-6522
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Fax | 469-621-2209
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Provider Business Mailing Address
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Address Line | PO BOX 10147
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City | CONWAY
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State | AR
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Zip | 72034-0001
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Country | US
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Telephone | 501-358-6522
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Fax | 469-621-2209
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Authorized Official
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Title or Position | NP
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Name | KIMBERLY SIMS
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Credential |
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Telephone | 870-659-0006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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