Provider Demographics
NPI:1689166886
Name:HIBBS, SCHASTA LYN (APRN)
Entity type:Individual
Prefix:
First Name:SCHASTA
Middle Name:LYN
Last Name:HIBBS
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 1:128 HARMONY PARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS NATIONAL PARK
Mailing Address - State:AR
Mailing Address - Zip Code:71913-5404
Mailing Address - Country:US
Mailing Address - Phone:501-881-4988
Mailing Address - Fax:501-881-4788
Practice Address - Street 1:128 HARMONY PARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS NATIONAL PARK
Practice Address - State:AR
Practice Address - Zip Code:71913-5404
Practice Address - Country:US
Practice Address - Phone:501-881-4988
Practice Address - Fax:501-881-4788
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA0005646363LF0000X
ARA005646363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily