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General NPI Number Information
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NPI Number | 1609647015
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Entity Type | Individual
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Provider Name | NELSON MISHLER
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Gender | Male
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 09/27/2025
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Provider Practice Location Address
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Address Line | 609 W MAPLE AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-5335
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Country | US
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Telephone | 479-751-5711
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 ARI AVE
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City | CENTERTON
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State | AR
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Zip | 72719-7074
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Country | US
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Telephone | 530-957-4251
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 340705
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License Number State | LA
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