Provider Demographics
NPI:1972127793
Name:VINCENT, MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:VINCENT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HARMONY PARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5404
Mailing Address - Country:US
Mailing Address - Phone:501-881-4988
Mailing Address - Fax:501-881-4988
Practice Address - Street 1:128 HARMONY PARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-5404
Practice Address - Country:US
Practice Address - Phone:501-881-4988
Practice Address - Fax:501-881-4755
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR124325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily