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General NPI Number Information
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NPI Number | 1801023247
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Entity Type | Individual
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Provider Name | PRINCESS S HOUSTON BA
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Gender | Female
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Dates
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Enumeration Date | 06/12/2009
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 2712 E JOHNSON AVE
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City | JONESBORO
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State | AR
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Zip | 72405-1874
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Country | US
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Telephone | 870-932-2800
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Fax |
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Provider Business Mailing Address
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Address Line | 1510 BYRUM RD
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City | BLYTHEVILLE
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State | AR
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Zip | 72315-8033
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Country | US
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Telephone | 870-532-2600
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 233020
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License Number State | AR
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