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General NPI Number Information
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NPI Number | 1700403128
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Entity Type | Individual
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Provider Name | TINA MICHELLE WILDER SLIGER APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2020
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Last Update Date | 12/15/2023
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Provider Practice Location Address
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Address Line | 3525 AR-5 SUITE 200
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City | BRYANT
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State | AR
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Zip | 72019
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Country | US
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Telephone | 501-333-6654
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Fax | 833-906-2595
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Provider Business Mailing Address
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Address Line | 103 ARROWHEAD RD
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City | MALVERN
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State | AR
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Zip | 72104-3675
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Country | US
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Telephone | 501-762-3691
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 125504
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License Number State | AR
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