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General NPI Number Information
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NPI Number | 1285391300
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Entity Type | Organization
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Legal Business Name | RENEW AND REVIVE, PLLC
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Dates
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Enumeration Date | 11/23/2021
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Last Update Date | 11/23/2021
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Provider Practice Location Address
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Address Line | 1111 E WALNUT ST
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City | PARIS
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State | AR
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Zip | 72855-4123
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Country | US
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Telephone | 479-363-3247
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Fax | 479-777-8581
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Provider Business Mailing Address
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Address Line | 1111 E WALNUT ST
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City | PARIS
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State | AR
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Zip | 72855-4123
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Country | US
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Telephone | 479-363-3247
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Fax | 479-777-8581
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Authorized Official
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Title or Position | APRN
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Name | NETLLA CURETON
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Credential | FNP-C
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Telephone | 479-363-3247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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