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General NPI Number Information
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NPI Number | 1063195808
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Entity Type | Organization
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Legal Business Name | THRIVE PEDIATRIC NURSING INC
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Dates
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Enumeration Date | 08/09/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 254 W MULBERRY AVE STE 3
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City | SEARCY
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State | AR
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Zip | 72143-6709
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Country | US
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Telephone | 501-353-1422
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Fax | 888-901-2003
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Provider Business Mailing Address
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Address Line | 7197 SHERIDAN RD STE 105
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City | WHITE HALL
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State | AR
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Zip | 71602-3261
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Country | US
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Telephone | 870-329-8252
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Fax | 888-901-2003
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHELLE M MANTUANO
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Credential |
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Telephone | 870-247-6131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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