Healthcare Provider Details

I. General information

NPI: 1013072602
Provider Name (Legal Business Name): MS. JANICE NIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 12/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DONS WAY
HOT SPRINGS AR
71913-3423
US

IV. Provider business mailing address

125 DONS WAY
HOT SPRINGS AR
71913
US

V. Phone/Fax

Practice location:
  • Phone: 501-624-7111
  • Fax: 501-620-5109
Mailing address:
  • Phone: 501-620-5130
  • Fax: 501-620-5109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number94891
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: