Healthcare Provider Details

I. General information

NPI: 1407552557
Provider Name (Legal Business Name): REBECCA ELLEN STEWART APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2023
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 S 54TH ST STE 1
ROGERS AR
72758-8125
US

IV. Provider business mailing address

602 ARCADIA DR
BENTONVILLE AR
72712-3534
US

V. Phone/Fax

Practice location:
  • Phone: 479-396-5200
  • Fax: 833-963-1060
Mailing address:
  • Phone: 479-616-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR041145
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR041145
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberR041145
License Number StateAR
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number222391
License Number StateAR
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number222391
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: