Provider Demographics
NPI:1578913307
Name:HEARN HEALTH PA
Entity Type:Organization
Organization Name:HEARN HEALTH PA
Other - Org Name:OCCUPATIONAL HEALTH CONSULTATION AND REHABILITATION SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, DPT
Authorized Official - Phone:501-336-4035
Mailing Address - Street 1:506 W RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-5523
Mailing Address - Country:US
Mailing Address - Phone:501-336-4035
Mailing Address - Fax:501-336-4035
Practice Address - Street 1:506 W RIDGE DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72034-5523
Practice Address - Country:US
Practice Address - Phone:501-336-4035
Practice Address - Fax:501-336-4035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004568363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty