Basic Information
| Provider Information | |||||||||
| NPI: | 1548927619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMITHSON | ||||||||
| FirstName: | LORETTA | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | ACCESS MEDICAL CLINIC ARKANSAS LLC | ||||||||
| Address2: | 106 HWY 62 WEST | ||||||||
| City: | SALEM | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72576 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708561202 | ||||||||
| FaxNumber: | 8708562107 | ||||||||
| Practice Location | |||||||||
| Address1: | GREENHURST NURSING CENTER | ||||||||
| Address2: | 226 SKYLER DRIVE | ||||||||
| City: | CHARLESTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72933 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799657373 | ||||||||
| FaxNumber: | 4799650340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2021 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 217886 | AR | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.