Provider Demographics
NPI:1962654384
Name:ARKANSAS CHILDREN'S HOSPITAL
Entity Type:Organization
Organization Name:ARKANSAS CHILDREN'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVANCE PRACTICE NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:JO
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:GREENHILL
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:501-364-5342
Mailing Address - Street 1:12614 VALLEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3353
Mailing Address - Country:US
Mailing Address - Phone:501-343-1069
Mailing Address - Fax:
Practice Address - Street 1:800 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3510
Practice Address - Country:US
Practice Address - Phone:501-364-5342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03167 ANP282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren