Organization Name: | ST. ANTHONY'S HOSPITAL ASSOCIATION |
NPI Number: | 1215915459 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JANE A JACKSON (CLINIC COORDINATOR) |
Mailing Address: | 4 Hospital Drive Morrilton |
State: | AR US |
Postal Code: | 721104510 |
Phone Number: | 5013544637 |
Fax Number: | 5013542248 |
NPI Enumeration Date: | 01/06/2006 |
NPI Last Update Date: | 05/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A01404 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |