# HENDERSON STATE UNIVERSITY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HENDERSON STATE UNIVERSITY
- **Other names:** Student Health and Wellness
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043968894
- **Legal business name:** HENDERSON STATE UNIVERSITY
- **Authorized official:** RENEE WALLS APRN (INTERIM DIRECTOR)
- **Authorized official phone:** (870) 230-5102

## Contact information

- **Practice address:** 1100 HENDERSON ST, ARKADELPHIA, AR 71999-0001
- **Practice address phone:** (870) 230-5102
- **Mailing address:** 1100 HENDERSON ST, ARKADELPHIA, AR 71999-0001
- **Mailing address phone:** (870) 230-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2022
- **Last updated:** 03/15/2022