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General NPI Number Information
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NPI Number | 1619557154
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Entity Type | Individual
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Provider Name | BERNICE ANDERSON
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Gender | Female
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 1699 HARRISON ST STE D
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City | BATESVILLE
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State | AR
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Zip | 72501-7318
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Country | US
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Telephone | 870-262-6282
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Fax | 870-262-6290
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Provider Business Mailing Address
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Address Line | 109 PHYSICIANS DR STE C
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City | GREER
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State | SC
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Zip | 29650-2446
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Country | US
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Telephone |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | E-19060
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License Number State | AR
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