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General NPI Number Information
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NPI Number | 1679006969
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Entity Type | Individual
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Provider Name | CAROL ANN PIATKOWSKI APRN
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Gender | Female
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Dates
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Enumeration Date | 04/04/2017
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Last Update Date | 02/14/2023
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Provider Practice Location Address
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Address Line | 3493 BELLA VISTA WAY
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City | BELLA VISTA
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State | AR
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Zip | 72714-5740
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Country | US
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Telephone | 479-265-3712
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Fax | 479-265-3713
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Provider Business Mailing Address
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Address Line | 3493 BELLA VISTA WAY
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City | BELLA VISTA
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State | AR
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Zip | 72714-5740
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Country | US
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Telephone | 479-265-3712
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Fax | 479-265-3713
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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 | A005006
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License Number State | AR
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