MEDICARE: NATURAL STATE IVY

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	2083P0901X	Public Health & General Preventive Medicine Physician

General Provider Information

NPI Number	:	1265154272
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL STATE IVY

Provider Business Mailing Address
First Line	:	301 MAIN ST STE 202
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-4918
Country	:	US
Telephone Number	:	501-208-7037
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 MAIN ST STE 202
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72114-4918
Country	:	US
Telephone Number	:	501-621-2442
Fax Number	:	501-687-5234

Authorized Official
Title or Position	:	OWNER/NP
Name	:	DARREL COLBY HAWLEY
Credential	:	NP
Telephone Number	:	501-208-7037

Provider Enumeration Date	:	09/15/2022
Last Update Date	:	12/08/2025

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1336854975 — MR. DARREL COLBY HAWLEY MSN, APRN, FNP-C
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Practice Fax: 501-687-5234

Directions to “NATURAL STATE IVY ” Practice Location

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