Basic Information
Provider Information
NPI: 1083150304
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HULL
FirstName: HONEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 108 N SHACKLEFORD RD
Address2:  
City: LITTLE ROCK
State: AR
PostalCode: 722112840
CountryCode: US
TelephoneNumber: 5017122571
FaxNumber: 5014047789
Practice Location
Address1: 148 SAWTOOTH OAK ST
Address2:  
City: HOT SPRINGS
State: AR
PostalCode: 719017160
CountryCode: US
TelephoneNumber: 8442150731
FaxNumber: 5014047789
Other Information
ProviderEnumerationDate: 01/10/2017
LastUpdateDate: 04/05/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/05/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XA004883ARY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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