Provider Demographics
NPI:1932591179
Name:HERMAN, DESIREE D (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:D
Last Name:HERMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 N HOPEWELL LOOP RD
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823-7597
Mailing Address - Country:US
Mailing Address - Phone:479-857-8950
Mailing Address - Fax:
Practice Address - Street 1:425 W CAPITOL AVE STE 435
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3642
Practice Address - Country:US
Practice Address - Phone:501-209-8671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215223363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily