Basic Information
| Provider Information | |||||||||
| NPI: | 1417051129 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEEK | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | O | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 578 | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 726020578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707413592 | ||||||||
| FaxNumber: | 8707417733 | ||||||||
| Practice Location | |||||||||
| Address1: | 707 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707413592 | ||||||||
| FaxNumber: | 8707417733 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2006 | ||||||||
| LastUpdateDate: | 12/05/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | A01685 | AR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | A001685 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 166820758 | 05 | AR | MEDICAID |