Healthcare Provider Details

I. General information

NPI: 1275638728
Provider Name (Legal Business Name): BERNA K SMEDLEY APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 09/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 PONCE DE LEON DR
HOT SPRINGS VILLAGE AR
71909-8121
US

IV. Provider business mailing address

410 PONCE DE LEON DR
HOT SPRINGS VILLAGE AR
71909-8121
US

V. Phone/Fax

Practice location:
  • Phone: 501-922-1700
  • Fax: 501-922-0826
Mailing address:
  • Phone: 501-922-1700
  • Fax: 501-922-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAO1653APN
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01653
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: