Individual
MRS. JOY ANGELA CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202
(501) 364-1100
(501) 364-2963
Mailing address
1 CHILDRENS WAY # 653, LITTLE ROCK, AR 72202-3500
(501) 364-1100
(501) 364-2963
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
A01476
AR
363LP0200X
Pediatric Nurse Practitioner
Primary
A001476
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193508758
MEDACAID PROVIDER NUMBER
AR
Enumeration date
11/05/2012
Last updated
05/31/2018
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