Individual
ETHAN PEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
7001 ROGERS AVE, FORT SMITH, AR 72903-4073
(479) 314-6000
Mailing address
476954 E 1094 RD, ROLAND, OK 74954-5061
(479) 926-6037
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
132425
OK
363LF0000X
Family Nurse Practitioner
Primary
201449
OK
363LF0000X
Family Nurse Practitioner
214768
AR
Other
Enumeration date
12/23/2020
Last updated
09/02/2022
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