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Organization

MISTY ZELK, M.D., P.L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SHANNON A HARTER (CLINIC MANAGER)
(501) 225-9990
Entity
Organization

Contact information

Practice address
11908 KANIS RD, SUITE G-8, LITTLE ROCK, AR 72211-3733
(501) 225-9990
(501) 225-9998
Mailing address
11908 KANIS RD, SUITE G-8, LITTLE ROCK, AR 72211-3733
(501) 225-9990
(501) 225-9998

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E1505
AR
363L00000X
Nurse Practitioner
A01721
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1730109877
INDIVIDUAL NPI NUMBER
AR
01
1962401463
ZELK NPI
AR
Enumeration date
04/24/2007
Last updated
12/05/2007
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