Healthcare Provider Details

I. General information

NPI: 1619083466
Provider Name (Legal Business Name): CHRISTINE G. PINGEL RNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRIS G. PINGEL RNP

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N GARLAND AVE
FAYETTEVILLE AR
72701-3110
US

IV. Provider business mailing address

76 MAYFAIR DR
BELLA VISTA AR
72715-5390
US

V. Phone/Fax

Practice location:
  • Phone: 479-575-4478
  • Fax:
Mailing address:
  • Phone: 479-855-2037
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberPO1559
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: