Provider Demographics
NPI:1316322787
Name:RUFFNER, ALISA DANIELLE (DNP)
Entity type:Individual
Prefix:DR
First Name:ALISA
Middle Name:DANIELLE
Last Name:RUFFNER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:
Other - Last Name:WHITFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6031 CHARLEY PL
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72019-8937
Mailing Address - Country:US
Mailing Address - Phone:501-651-2000
Mailing Address - Fax:501-651-2394
Practice Address - Street 1:1636 HIGDON FERRY RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6912
Practice Address - Country:US
Practice Address - Phone:501-651-2000
Practice Address - Fax:501-651-2394
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004449363LF0000X, 363LA2100X
AR084250363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care