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General NPI Number Information
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NPI Number | 1861862914
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Entity Type | Organization
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Legal Business Name | MCREYNOLDS WELLNESS CLINIC PLLC
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 03/29/2018
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Provider Practice Location Address
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Address Line | 5300 S SOUTHERN HILLS CT STE 100
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City | ROGERS
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State | AR
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Zip | 72758-3500
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Country | US
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Telephone | 479-636-1324
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Fax | 479-372-4433
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Provider Business Mailing Address
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Address Line | 5300 S SOUTHERN HILLS CT STE 100
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City | ROGERS
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State | AR
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Zip | 72758-3500
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Country | US
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Telephone | 479-636-1324
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Fax | 479-372-4433
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Authorized Official
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Title or Position | APRN/OWNER
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Name | SARAH JANE MCREYNOLDS BRINKLEY
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Credential | APRN, ACNS-BC
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Telephone | 479-224-6368
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | S02246
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License Number State | AR
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