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General NPI Number Information
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NPI Number | 1417465998
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Entity Type | Individual
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Provider Name | MEREDITH PAIGE ROBERTSON APRN
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Gender | Female
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Dates
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Enumeration Date | 01/18/2018
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 2900 SE MOBERLY LN
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City | BENTONVILLE
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State | AR
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Zip | 72712
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Country | US
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Telephone | 479-273-1550
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Fax | 479-273-3330
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Provider Business Mailing Address
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Address Line | 2900 SE MOBERLY LN
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City | BENTONVILLE
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State | AR
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Zip | 72712-3748
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Country | US
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Telephone | 479-273-1550
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Fax | 479-273-3330
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A005492
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A005492
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License Number State | AR
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