Basic Information
| Provider Information | |||||||||
| NPI: | 1932879350 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARTZ | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | |||||||||
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| Credential: | DNP, APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2008 FAIRWAY ST | ||||||||
| Address2: | |||||||||
| City: | STUTTGART | ||||||||
| State: | AR | ||||||||
| PostalCode: | 721606927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8707180003 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4747 DUSTY LAKE DR STE 101 | ||||||||
| Address2: | |||||||||
| City: | PINE BLUFF | ||||||||
| State: | AR | ||||||||
| PostalCode: | 716039057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705366600 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2021 | ||||||||
| LastUpdateDate: | 08/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 215947 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.