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General NPI Number Information
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NPI Number | 1063232197
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Entity Type | Organization
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Legal Business Name | NEW WAY WELLNESS
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 2200 SE J ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-4185
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Country | US
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Telephone | 479-534-9248
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Fax |
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Provider Business Mailing Address
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Address Line | 2200 SE J ST STE 12
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City | BENTONVILLE
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State | AR
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Zip | 72712-4186
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Country | US
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Telephone | 479-364-0462
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Fax | 479-364-0482
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Authorized Official
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Title or Position | APRN
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Name | STEPHANIE BURKS
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Credential |
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Telephone | 479-364-0462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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