Provider Demographics
NPI:1780557603
Name:STONE, NATHAN TYLER (CIT, RDS)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:TYLER
Last Name:STONE
Suffix:
Gender:M
Credentials:CIT, RDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3942 E MONITOR RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72764-2602
Mailing Address - Country:US
Mailing Address - Phone:479-256-8688
Mailing Address - Fax:479-770-5137
Practice Address - Street 1:2810 W WALNUT ST STE C
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0318
Practice Address - Country:US
Practice Address - Phone:479-256-8688
Practice Address - Fax:479-770-5137
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator