Provider Demographics
NPI:1114922010
Name:SAYNER, DORIS VIRGINIA (ANP)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:VIRGINIA
Last Name:SAYNER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1529
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031-1529
Mailing Address - Country:US
Mailing Address - Phone:501-745-7888
Mailing Address - Fax:501-745-4401
Practice Address - Street 1:465 MEDICAL CENTER PARKWAY
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:AR
Practice Address - Zip Code:72031-1529
Practice Address - Country:US
Practice Address - Phone:501-745-7888
Practice Address - Fax:501-745-4401
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01232 ANP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y073Medicare ID - Type Unspecified
ARQ26324Medicare UPIN