Healthcare Provider Details

I. General information

NPI: 1710363775
Provider Name (Legal Business Name): TRUPHENA NYABOKE OROO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2015
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2274 LAKESIDE AVE
SPRINGDALE AR
72764-7213
US

IV. Provider business mailing address

2274 LAKESIDE AVE
SPRINGDALE AR
72764-7213
US

V. Phone/Fax

Practice location:
  • Phone: 479-422-8509
  • Fax:
Mailing address:
  • Phone: 479-422-8509
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberA004479
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberA004479
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberA004479
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: