1902534662 NPI number — APRN ASSOCIATES OF ARKANSAS

Table of content: (NPI 1902534662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902534662 NPI number — APRN ASSOCIATES OF ARKANSAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APRN ASSOCIATES OF ARKANSAS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902534662
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
612 W COMMERCE DR STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRYANT
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72022-7517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-291-3699
Provider Business Mailing Address Fax Number:
520-476-3792

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
612 W COMMERCE DR STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRYANT
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72022-7517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-291-3699
Provider Business Practice Location Address Fax Number:
520-476-3792
Provider Enumeration Date:
08/10/2022

Additional Information

Authorized Official

Authorized Official Last Name:
MCCOMBS
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
LAMONT
Authorized Official Title or Position:
APRN/OWNER
Authorized Official Telephone Number:
501-291-3699

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 232728758 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 292400762 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com