Provider Demographics
NPI:1164114096
Name:SPARKS, LAURA L (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:SPARKS
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W. PARK ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:AR
Mailing Address - Zip Code:72744
Mailing Address - Country:US
Mailing Address - Phone:479-381-4167
Mailing Address - Fax:479-404-4397
Practice Address - Street 1:106 W. PARK ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:AR
Practice Address - Zip Code:72744
Practice Address - Country:US
Practice Address - Phone:479-381-4167
Practice Address - Fax:479-404-4397
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR223455363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily