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General NPI Number Information
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NPI Number | 1275641987
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Entity Type | Individual
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Provider Name | PENELOPE POLLOCK APN/CNS, RNP, RN
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 4300 W 7TH ST
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City | LITTLE ROCK
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State | AR
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Zip | 72205-5446
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Country | US
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Telephone | 501-257-3085
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Fax | 501-257-3025
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Provider Business Mailing Address
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Address Line | 5 CHELSEA RD
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City | LITTLE ROCK
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State | AR
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Zip | 72212-3723
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Country | US
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Telephone |
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | R21899
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | P00437
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 364SA2200X
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Taxonomy Name | Adult Health Clinical Nurse Specialist
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License Number | S01083
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License Number State | AR
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