Healthcare Provider Details

I. General information

NPI: 1326511858
Provider Name (Legal Business Name): GLORIAANNE CARRINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2019
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 S PINNACLE HILLS PKWY STE 300
ROGERS AR
72758-9100
US

IV. Provider business mailing address

3333 S PINNACLE HILLS PKWY STE 300
ROGERS AR
72758-9100
US

V. Phone/Fax

Practice location:
  • Phone: 479-338-6086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License NumberR37043
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: