Provider Demographics
NPI:1205362969
Name:WINNINGHAM, ELIZABETH (APRN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WINNINGHAM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:NIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1300 CENTERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4349
Mailing Address - Country:US
Mailing Address - Phone:501-410-1196
Mailing Address - Fax:501-410-1148
Practice Address - Street 1:11321 INTERSTATE 30
Practice Address - Street 2:SUITE 101
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-7040
Practice Address - Country:US
Practice Address - Phone:501-455-1331
Practice Address - Fax:501-455-5597
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005059363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily