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Organization
SELAH HEALTH
Active
Organization
SELAH HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA GAIL SMALLMON APRN (CEO)
(870) 970-3180
Entity
Organization
Contact information
Practice address
180 S THORNTON AVE, PIGGOTT, AR 72454-2731
(870) 970-3180
(870) 343-6262
Mailing address
PO BOX 301, PIGGOTT, AR 72454-0301
(870) 970-3180
(870) 201-9686
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
163WW0000X
Wound Care Registered Nurse
—
NULL
163WW0000X
Wound Care Registered Nurse
—
—
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447481072
AMANDA SMALLMON'S NPI #
—
01
—
1518246438
TAMMY TRIPP, LSCW, NPI#
—
05
—
291504758
—
AR
Enumeration date
02/23/2022
Last updated
05/11/2024
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