MEDICARE: MRS. CHRISTY WUST APRN

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	363LF0000X	Family Nurse Practitioner	123830	AR

General Provider Information

NPI Number	:	1710519673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTY WUST APRN

Provider Business Mailing Address
First Line	:	2301 CHAMPAGNOLLE RD
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4816
Country	:	US
Telephone Number	:	870-865-7908
Fax Number	:	870-639-9844

Provider Business Practice Location Address
First Line	:	2301 CHAMPAGNOLLE RD
Second Line	:
City	:	EL DORADO
State	:	AR
Zip	:	71730-4816
Country	:	US
Telephone Number	:	870-865-7908
Fax Number	:	870-639-9844

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

Provider Enumeration Date	:	02/09/2020
Last Update Date	:	07/29/2025

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