Healthcare Provider Details

I. General information

NPI: 1013394287
Provider Name (Legal Business Name): VALERIE BEDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2015
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 MEDICAL CENTER PKWY STE 240B
BENTONVILLE AR
72712-3204
US

IV. Provider business mailing address

2422 N THOMPSON ST SUITE A
SPRINGDALE AR
72764-1757
US

V. Phone/Fax

Practice location:
  • Phone: 479-553-2200
  • Fax:
Mailing address:
  • Phone: 479-757-5025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA004394
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: