Organization · NPI-2

Elevation Family Healthcare, PLLC

Family Medicine · Farmington, AR

NPI number1174491468
StatusActive
Last updated in NPPESOct 28, 2025

Details

NPI
1174491468
Entity type
Organization (NPI-2)
Legal business name
Elevation Family Healthcare, PLLC
Organization subpart
No
Enumeration date
Oct 28, 2025
Certification date
Oct 7, 2025
Last updated
Oct 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

11112 Shumate Crossing Rd
Farmington, AR 72730

Phone 479-530-4744 · Fax 479-530-4744

Mailing address

11112 Shumate Crossing Rd
Farmington, AR 72730-8792

Phone 479-530-4744 · Fax 479-530-4744

Authorized official

Charlene Mae Jaques
Owner/Employee
4795304744

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