WILD FIG LLC NPI 1770399305

NPI Information

  • NPI: 1770399305
  • Provider Name: WILD FIG, LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 215 N COLLEGE AVE
    FAYETTEVILLE, AR
    ZIP 72701
  • Phone: (479) 301-5290

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NPI Details

WILD FIG, LLC is a psychiatric/mental health nurse practitioner in Fayetteville, AR. WILD FIG, LLC NPI is 1770399305. The provider is registered as an organization entity type.

The provider's business location address is:

215 N COLLEGE AVE
FAYETTEVILLE, AR
ZIP 72701-238
Phone: (479) 301-5290

The provider's authorized official is Connie Marie Thomas .
The authorized official title is Owner/nurse Practitioner and has the following contact phone number (618) 554-8730.

The enumeration date for this NPI number is 12/9/2024 and was last updated on 12/9/2024.

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
1261Q00000XClinic/CenterNo
2261QM0850XClinic/CenterAdult Mental HealthNo
3261QM0855XClinic/CenterAdolescent and Children Mental HealthNo
4261QR0405XClinic/CenterRehabilitation, Substance Use DisorderNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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: 11/21/2025

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