MEDICARE: INNER LIGHT INTEGRATIVE HEALTH, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1154203917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER LIGHT INTEGRATIVE HEALTH, PLLC

Provider Business Mailing Address
First Line	:	7609 HORAN DR
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72903-5109
Country	:	US
Telephone Number	:	479-430-8261
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 FORT ST STE J
Second Line	:
City	:	BARLING
State	:	AR
Zip	:	72923-2045
Country	:	US
Telephone Number	:	479-430-8261
Fax Number	:	800-420-2695

Authorized Official
Title or Position	:	NURSE PRACTITIONER
Name	:	MRS. SARAH ROSE ANDERSON
Credential	:	APRN
Telephone Number	:	479-430-8261

Provider Enumeration Date	:	07/23/2025
Last Update Date	:	07/23/2025

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