Provider Demographics
NPI:1174496871
Name:MISTLER, VIRGINIA (APRN)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:MISTLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 STATE HIGHWAY 22 W
Mailing Address - Street 2:
Mailing Address - City:DARDANELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72834-2907
Mailing Address - Country:US
Mailing Address - Phone:479-477-3084
Mailing Address - Fax:479-477-3085
Practice Address - Street 1:1714 STATE HIGHWAY 22 W
Practice Address - Street 2:
Practice Address - City:DARDANELLE
Practice Address - State:AR
Practice Address - Zip Code:72834-2907
Practice Address - Country:US
Practice Address - Phone:479-477-3084
Practice Address - Fax:479-477-3085
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR234951363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily