Healthcare Provider Details

I. General information

NPI: 1598940322
Provider Name (Legal Business Name): DONNA MARIE RHEA APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CREASON RD
CORNING AR
72422-1716
US

IV. Provider business mailing address

PO BOX 83
CORNING AR
72422-0083
US

V. Phone/Fax

Practice location:
  • Phone: 870-857-3399
  • Fax: 870-857-3301
Mailing address:
  • Phone: 870-857-3399
  • Fax: 870-857-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01397
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: