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General NPI Number Information
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NPI Number | 1992553028
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Entity Type | Organization
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Legal Business Name | VENVISOR HEALTH OF AR PA
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Dates
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Enumeration Date | 05/13/2024
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 1202 NE MCCLAIN RD BLDG 7
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City | BENTONVILLE
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State | AR
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Zip | 72712-3875
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Country | US
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Telephone | 203-901-2493
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Fax | 866-497-2991
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Provider Business Mailing Address
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Address Line | PO BOX 986500
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City | BOSTON
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State | MA
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Zip | 02298-6500
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Country | US
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Telephone | 203-901-2493
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Fax | 866-497-2991
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Authorized Official
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Title or Position | OWNER
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Name | DAVID PENRY
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Credential |
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Telephone | 203-901-2493
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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