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Individual

TY ANTHONY HUMPHREYS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
1723 MALVERN AVE, HOT SPRINGS, AR 71901-7133
(888) 710-8220
(866) 573-0761
Mailing address
PO BOX 1848, MENA, AR 71953-1841
(479) 437-3449
(479) 243-0285

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
218850
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588396600
AR
Enumeration date
06/28/2022
Last updated
05/27/2023
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