Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Northwest Arkansas Functional Health LLC

Organization Nurse Practitioner · NPI 1417669029

Northwest Arkansas Functional Health LLC provides Nurse Practitioner services in Tontitown, Arkansas. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

246 S Maestri Rd Ste 2
Tontitown, AR 72762-9703
Phone: (479) 220-9909
Fax: (888) 675-9637
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X

Record details

NPI number1417669029
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brent Rush — Arpn · (479) 220-9951
NPI enumeratedDecember 15, 2022
Last updated in NPPESDecember 15, 2022
Certification dateDecember 15, 2022
Mailing address20398 Bill Young Rd, Siloam Springs, AR 72761-8921