Provider Demographics
NPI:1639370646
Name:ARKADELPHIA HEALTH AND FAMILY CLINIC, LLC
Entity Type:Organization
Organization Name:ARKADELPHIA HEALTH AND FAMILY CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCED PRACTICE NURSE
Authorized Official - Prefix:MISS
Authorized Official - First Name:AIMEE
Authorized Official - Middle Name:MONETTE
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:870-246-1652
Mailing Address - Street 1:208 N 26TH ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4337
Mailing Address - Country:US
Mailing Address - Phone:870-246-1652
Mailing Address - Fax:870-246-6995
Practice Address - Street 1:208 N 26TH ST
Practice Address - Street 2:SUITE C
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4337
Practice Address - Country:US
Practice Address - Phone:870-246-1652
Practice Address - Fax:870-246-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP05803019101YP2500X
ARC8415207Q00000X
ARA01539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X720OtherAIMEE HUGHES, APN BLUECR#
ARMH0750112OtherAIMEE HUGHES, APN DEA#
ARMH0750112OtherAIMEE HUGHES, APN DEA#