Provider Demographics
NPI:1619359171
Name:MAY, LARA A (DNP, APRN, NP-C)
Entity type:Individual
Prefix:DR
First Name:LARA
Middle Name:A
Last Name:MAY
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 HIGHWAY 5 N
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-3027
Mailing Address - Country:US
Mailing Address - Phone:870-232-0900
Mailing Address - Fax:870-232-0888
Practice Address - Street 1:230 HIGHWAY 5 N STE 10
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3013
Practice Address - Country:US
Practice Address - Phone:870-232-0900
Practice Address - Fax:870-232-0888
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR212861363LF0000X, 363LW0102X, 363L00000X
MO2015019788363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO13553283OtherCAQH
MOF0615956OtherAANP CERTIFICATION NUMBER