Healthcare Provider Details

I. General information

NPI: 1295669851
Provider Name (Legal Business Name): MONICA WITTSCHEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 S THOMPSON ST
SPRINGDALE AR
72764-4240
US

IV. Provider business mailing address

6513 ELIZABETH AVE
SPRINGDALE AR
72762-4143
US

V. Phone/Fax

Practice location:
  • Phone: 479-200-0109
  • Fax:
Mailing address:
  • Phone: 479-200-0109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number055060
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: