Provider Demographics
NPI:1417051129
Name:CHEEK, ELIZABETH O (APRN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:O
Last Name:CHEEK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 578
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-0578
Mailing Address - Country:US
Mailing Address - Phone:870-741-3592
Mailing Address - Fax:870-741-7733
Practice Address - Street 1:707 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601
Practice Address - Country:US
Practice Address - Phone:870-741-3592
Practice Address - Fax:870-741-7733
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01685363LF0000X
ARA001685363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR166820758Medicaid
AR166820758Medicaid
ARP71111Medicare UPIN