Provider Demographics
NPI:1285292425
Name:JOURNEY WELLNESS CLINIC
Entity type:Organization
Organization Name:JOURNEY WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, APRN, PMHNP-BC
Authorized Official - Phone:501-551-6412
Mailing Address - Street 1:7416 GLENN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-4338
Mailing Address - Country:US
Mailing Address - Phone:501-551-6412
Mailing Address - Fax:
Practice Address - Street 1:5401 JFK BLVD STE E-1
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6756
Practice Address - Country:US
Practice Address - Phone:501-551-6412
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty