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General NPI Number Information
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NPI Number | 1497749428
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Entity Type | Individual
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Provider Name | SCARLET DENISE TRAVIS APN
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Gender | Female
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Dates
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Enumeration Date | 09/06/2005
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 500 S 52ND ST
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City | ROGERS
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State | AR
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Zip | 72758-8600
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Country | US
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Telephone | 479-254-9662
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Fax | 479-254-9652
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Provider Business Mailing Address
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Address Line | 3101 SE 14TH ST
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City | BENTONVILLE
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State | AR
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Zip | 72712-4900
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Country | US
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Telephone | 479-636-9234
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Fax | 479-636-0774
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | A01448
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License Number State | AR
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