# DEPARTMENT OF HEALTH AND HUMAN SERVICES DIVISION OF HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497878904
- **Authorized official:** MS. SUZANNE MICHAEL RNP (RNP II)
- **Authorized official phone:** (501) 772-7875

## Contact information

- **Practice address:** 5800 W 10TH ST, LITTLE ROCK, AR 72204-1752
- **Practice address phone:** (501) 280-4940
- **Mailing address:** 3108 TANNER TRL, LITTLE ROCK, AR 72210-1539
- **Mailing address phone:** (501) 772-7875

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | P00723 | AR | Yes |

## Other

- **Enumeration date:** 04/09/2007
- **Last updated:** 08/22/2020