Healthcare Provider Details

I. General information

NPI: 1598315913
Provider Name (Legal Business Name): MICHAELA R BERNDT FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

808 S 52ND ST
ROGERS AR
72758-8602
US

IV. Provider business mailing address

3901 PARKWAY CIR STE 100
SPRINGDALE AR
72762-5328
US

V. Phone/Fax

Practice location:
  • Phone: 479-587-1700
  • Fax:
Mailing address:
  • Phone: 479-587-1700
  • Fax: 479-587-1366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number122190
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: