ARC XPRESS HEALTHCARE CLINIC - NPI NUMBER 1972847218

Summary

Provider Name: ARC XPRESS HEALTHCARE CLINIC

NPI Number: 1972847218

Clasification: Nurse Practitioner (363LF0000X)

Specialization: Family

Address:
11524 N RODNEY PARHAM RD
SUITE 8
LITTLE ROCK, AR
ZIP 72212

Phone Number: (501) 954-7822



Detailed Information

ARC XPRESS HEALTHCARE CLINIC is a family nurse practitioner in Little Rock, AR. The assigned NPI number for this provider is 1972847218 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

11524 N RODNEY PARHAM RD
SUITE 8
LITTLE ROCK, AR
ZIP 72212-187
Phone: (501) 954-7822
Fax: (888) 269-8002

The provider's authorized official is Donna Ruth Wright .
The authorized official title is Advanced Nurse Practitioner/ceo and has the following contact phone number (501) 954-7822.

The enumeration date for this NPI number is 11/26/2012 and was last updated on 11/26/2012.

Map - Location of Practice

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Taxonomy Codes

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 363LF0000X Nurse Practitioner Family A01224 AR Yes

NPI Record

No. Field Name Field Value
1 NPI 1972847218
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name ARC XPRESS HEALTHCARE CLINIC
5 Provider First Line Business Practice Location Address 11524 N RODNEY PARHAM RD
6 Provider Second Line Business Practice Location Address SUITE 8
7 Provider Business Practice Location Address City Name LITTLE ROCK
8 Provider Business Practice Location Address State Name AR
9 Provider Business Practice Location Address Postal Code 722124187
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 5019547822
12 Provider Business Practice Location Address Fax Number 8882698002
13 Provider Enumeration Date 11/26/2012
14 Last Update Date 11/26/2012
15 Authorized Official Last Name WRIGHT
16 Authorized Official First Name DONNA
17 Authorized Official Middle Name RUTH
18 Authorized Official Title or Position ADVANCED NURSE PRACTITIONER/CEO
19 Authorized Official Telephone Number 5019547822
20 Healthcare Provider Taxonomy Code 1 363LF0000X
21 Provider License Number 1 A01224
22 Provider License Number State Code 1 AR
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Is Organization Subpart Y
25 Parent Organization LBN APPLIED RESEARCH CENTER OF ARKANSAS
26 Parent Organization TIN
27 Authorized Official Credential Text APN
28 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.