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General NPI Number Information
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NPI Number | 1942748488
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Entity Type | Organization
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Legal Business Name | INTEGRITY HEALTHCARE, LLC
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Dates
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Enumeration Date | 02/04/2017
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Last Update Date | 02/04/2017
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Provider Practice Location Address
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Address Line | 1210 S CHERRY ST STE 4
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City | PINE BLUFF
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State | AR
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Zip | 71601-5667
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Country | US
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Telephone | 870-329-4730
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2917
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City | PINE BLUFF
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State | AR
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Zip | 71613-2917
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Country | US
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Telephone | 870-329-4730
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Fax |
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER/PROVIDER
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Name | DR. CHANNOAH MCKINDRA WILLIAMS
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Credential | DNP, APN, FNP-BC
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Telephone | 870-329-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A03593
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License Number State | AR
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