Provider Demographics
NPI:1518925817
Name:SWEATT, DEBORAH KAY (ANP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:SWEATT
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:KAY
Other - Last Name:CONLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745
Mailing Address - Country:US
Mailing Address - Phone:479-463-7775
Mailing Address - Fax:479-463-7187
Practice Address - Street 1:199 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:AR
Practice Address - Zip Code:72730-3077
Practice Address - Country:US
Practice Address - Phone:479-267-1001
Practice Address - Fax:479-267-1026
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01155363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134821758Medicaid
ARS55754Medicare UPIN
AR5T934Medicare ID - Type Unspecified