Basic Information
| Provider Information | |||||||||
| NPI: | 1134368848 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEANS | ||||||||
| FirstName: | NAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3633 CENTRAL AVE STE N | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016236100 | ||||||||
| FaxNumber: | 5013214057 | ||||||||
| Practice Location | |||||||||
| Address1: | 3633 CENTRAL AVE STE N | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719136475 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016236100 | ||||||||
| FaxNumber: | 5013214057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2009 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | ATP-000194 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 178190758 | 05 | AR | MEDICAID | A003221 | 01 | AR | STATE LICENSE | OTHER |