Healthcare Provider Details

I. General information

NPI: 1851854905
Provider Name (Legal Business Name): PAMELA YVETTE MCARTHUR RN, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2019
Last Update Date: 04/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 SE WALTON BLVD STE 205
BENTONVILLE AR
72712-3768
US

IV. Provider business mailing address

13 DUNBARTON DR
BELLA VISTA AR
72715-6026
US

V. Phone/Fax

Practice location:
  • Phone: 479-544-0405
  • Fax:
Mailing address:
  • Phone: 479-544-0405
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberR022158
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: