Provider Demographics
NPI:1487440053
Name:PREWITT, ANNA (APRN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:PREWITT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:STANDRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2001 CLUB MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7777
Mailing Address - Country:US
Mailing Address - Phone:501-428-7040
Mailing Address - Fax:
Practice Address - Street 1:2001 CLUB MANOR DR
Practice Address - Street 2:
Practice Address - City:MAUMELLE
Practice Address - State:AR
Practice Address - Zip Code:72113-7777
Practice Address - Country:US
Practice Address - Phone:501-428-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-18
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR234878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily