Provider Demographics
NPI:1811638919
Name:TRAVIS, MANDI (FNP-C)
Entity type:Individual
Prefix:
First Name:MANDI
Middle Name:
Last Name:TRAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MANDI
Other - Middle Name:
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4196 HIGHWAY 62 412 STE A
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-8002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2804 E RACE AVE
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4776
Practice Address - Country:US
Practice Address - Phone:501-254-0911
Practice Address - Fax:501-254-0914
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR125704363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily