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General NPI Number Information
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NPI Number | 1598315913
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Entity Type | Individual
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Provider Name | MICHAELA R BERNDT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 808 S 52ND ST
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City | ROGERS
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State | AR
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Zip | 72758-8602
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Country | US
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Telephone | 479-587-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 PARKWAY CIR STE 100
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City | SPRINGDALE
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State | AR
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Zip | 72762-5328
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Country | US
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Telephone | 479-587-1700
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Fax | 479-587-1366
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 122190
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License Number State | AR
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