NEA RELIANT HEALTH CARE PROFESSIONALS INC NPI 1467829804

NPI Information

NEA RELIANT HEALTH CARE PROFESSIONALS INC is a family nurse practitioner in Bono, AR. NEA RELIANT HEALTH CARE PROFESSIONALS INC NPI is 1467829804. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bono Family Medical Clinic And Therapy Services.

The provider's business location address is:

9146 HIGHWAY 63 N
BONO, AR
ZIP 72416-153
Phone: (870) 930-9990
Fax: (870) 930-9992

The provider's authorized official is Jeremy Bergman .
The authorized official title is Owner and has the following contact phone number (870) 930-9990.

The CLIA number assigned to this NPI record is 04D2010489 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/1/2015 and was last updated on 12/28/2016.

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:

Other Identifiers

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

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