Provider Demographics
NPI:1376999607
Name:REYNA, SARAH ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:REYNA
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 1:1 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3353
Mailing Address - Country:US
Mailing Address - Phone:501-776-6901
Mailing Address - Fax:501-776-6908
Practice Address - Street 1:1 MEDICAL PARK DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3353
Practice Address - Country:US
Practice Address - Phone:501-776-6901
Practice Address - Fax:501-776-6908
Is Sole Proprietor?:No
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004658363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care