Provider Demographics
NPI:1568606754
Name:HEARN, NANCY LURLINE
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:LURLINE
Last Name:HEARN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 MYERS ST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72501-7344
Mailing Address - Country:US
Mailing Address - Phone:870-793-8925
Mailing Address - Fax:870-793-8929
Practice Address - Street 1:1800 MYERS ST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:AR
Practice Address - Zip Code:72501-7344
Practice Address - Country:US
Practice Address - Phone:870-793-8925
Practice Address - Fax:870-793-8929
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARM-4531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARNLHEARN1234Medicaid