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General NPI Number Information
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NPI Number | 1982418984
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Entity Type | Individual
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Provider Name | REAGAN VILLINES PMHNP
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 720 LEXINGTON AVE
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City | FORT SMITH
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State | AR
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Zip | 72901-4738
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Country | US
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Telephone | 479-910-3169
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Fax | 479-600-5051
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Provider Business Mailing Address
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Address Line | 124 WESTCHESTER CT
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City | HOT SPRINGS
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State | AR
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Zip | 71913-7743
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Country | US
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Telephone | 501-414-6446
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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 | 231939
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License Number State | AR
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