Healthcare Provider Details

I. General information

NPI: 1952895880
Provider Name (Legal Business Name): MAGGIE BARNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 06/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2153 E JOYCE BLVD STE 201
FAYETTEVILLE AR
72703-5285
US

IV. Provider business mailing address

23122 N HICKORY FLAT RD
HINDSVILLE AR
72738-9257
US

V. Phone/Fax

Practice location:
  • Phone: 479-575-9471
  • Fax:
Mailing address:
  • Phone: 479-841-9344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: