OUACHITA FAMILY PRACTICE LLC NPI 1225289978

NPI Information

NPI: 1225289978
Provider Name: OUACHITA FAMILY PRACTICE LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 04D0951056

Address:
1210 DEQUEEN ST
MENA, AR
ZIP 71953
Phone: (479) 394-5068
Get Directions

OUACHITA FAMILY PRACTICE LLC is a family nurse practitioner in Mena, AR. OUACHITA FAMILY PRACTICE LLC NPI is 1225289978. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1210 DEQUEEN ST
MENA, AR
ZIP 71953-132
Phone: (479) 394-5068
Fax: (479) 394-5626

The provider's authorized official is Debbie Kincaid .
The authorized official title is Practice Manager and has the following contact phone number (479) 394-5068.

The CLIA number assigned to this NPI record is 04D0951056 - practitioner other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/30/2008 and was last updated on 11/25/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		N6236	ARKANSAS	No
2	363LF0000X	Nurse Practitioner	Family	A03080ANP	ARKANSAS	No
3	363LF0000X	Nurse Practitioner	Family	A01300-ANP	ARKANSAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	175314762	MEDICAID	ARKANSAS
2	182122002	MEDICAID	ARKANSAS
3	5A866	OTHER	ARKANSAS	PTAN
4	5U119	OTHER	ARKANSAS	PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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