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General NPI Number Information
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NPI Number | 1104903517
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Entity Type | Individual
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Provider Name | VANESSA HARDIN BRANCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 2000 S 42ND ST STE 120
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City | ROGERS
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State | AR
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Zip | 72758-2001
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Country | US
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Telephone | 479-278-7153
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 S 42ND ST STE 120
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City | ROGERS
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State | AR
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Zip | 72758-2001
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Country | US
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Telephone | 479-278-7153
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | E-7764
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-7764
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License Number State | AR
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