Individual
ALLIE SPARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2505 COLLEGE AVE, CONWAY, AR 72034
(501) 327-6000
(501) 450-7559
Mailing address
2505 COLLEGE AVE, CONWAY, AR 72034
(501) 327-6000
(501) 450-7559
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
26665
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26665
TN HEALTH LICENSE
TN
Enumeration date
10/16/2019
Last updated
03/25/2022
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