MEDICARE: AMIE VINSON APRN, FNP-C

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	363LP2300X	Primary Care Nurse Practitioner	233844	AR

General Provider Information

NPI Number	:	1174411243
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMIE VINSON APRN, FNP-C

Provider Business Mailing Address
First Line	:	11001 EXECUTIVE CENTER DR STE 200
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72211-4393
Country	:	US
Telephone Number	:	870-881-8712
Fax Number	:	501-227-7787

Provider Business Practice Location Address
First Line	:	528 W FAULKNER ST
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4519
Country	:	US
Telephone Number	:	870-881-8712
Fax Number	:	501-227-7787

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2025
Last Update Date	:	01/02/2026

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