MEDICARE: MRS. ABIGAIL BONDS APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	125426	AR

General Provider Information

NPI Number	:	1346859147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABIGAIL BONDS APRN

Provider Business Mailing Address
First Line	:	175 VOLUNTEER PKWY
Second Line	:
City	:	CLINTON
State	:	AR
Zip	:	72031-8001
Country	:	US
Telephone Number	:	501-253-2287
Fax Number	:

Provider Business Practice Location Address
First Line	:	175 VOLUNTEER PKWY
Second Line	:
City	:	CLINTON
State	:	AR
Zip	:	72031-8001
Country	:	US
Telephone Number	:	501-745-3033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2020
Last Update Date	:	07/28/2020

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