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APN RAINBOW PEDIATRIC SERVICES PLLC NPI 1184825408


NPI Information

NPI: 1184825408
Provider Name: APN RAINBOW PEDIATRIC SERVICES, PLLC

Doing Business As: RAINBOW PEDIATRIC SERVICES, PLLC

Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
5507 WALSH LANE
STE 101
ROGERS, AR
ZIP 72758
Phone: (479) 464-8231
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APN RAINBOW PEDIATRIC SERVICES, PLLC is a nurse practitioner in Rogers, AR. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. APN RAINBOW PEDIATRIC SERVICES, PLLC NPI is 1184825408. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Rainbow Pediatric Services, Pllc.

The provider's business location address is:

5507 WALSH LANE
STE 101
ROGERS, AR
ZIP 72758-941
Phone: (479) 464-8231
Fax: (479) 464-8230

The provider's authorized official is Marilou Shreve-doffin .
The authorized official title is Owner and has the following contact phone number (479) 464-8231.

The enumeration date for this NPI number is 5/31/2007 and was last updated on 9/30/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsARKANSASNo
2363L00000XNurse PractitionerA01589ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1155833762MEDICAIDARKANSAS
25F294OTHERARKANSASAR BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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