=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639303340
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE ANNE CALVERY-CARMAN ANP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/08/2009
-----------------------------------------------------
Last Update Date | 05/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 934 N GASKILL ST
-----------------------------------------------------
City | HUNTSVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72740-1319
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-738-5500
-----------------------------------------------------
Fax | 479-738-1350
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1060
-----------------------------------------------------
City | MARSHALL
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72650-1060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 501-422-9229
-----------------------------------------------------
Fax | 501-325-5245
-----------------------------------------------------
=====================================================
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 | A003243
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A03243 ANP
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------