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NPI Code Detail

MEDICARE: DURINDA PENA A.P.N.

MEDICARE:   DURINDA  PENA  A.P.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerA02908 APNAR

General Provider Information

NPI Number : 1003841883
Entity Type Code : Individual
Provider Name (Legal Business Name) : DURINDA PENA A.P.N.
Provider Business Mailing Address
First Line : 3501 SW TOWN VU
Second Line :
City : BENTONVILLE
State : AR
Zip : 72712
Country : US
Telephone Number : 479-587-1700
Fax Number : 479-587-1366
Provider Business Practice Location Address
First Line : 3232 N NORTH HILLS BLVD.
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4005
Country : US
Telephone Number : 479-587-1700
Fax Number : 479-587-1366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/08/2007

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Directions to “ DURINDA PENA A.P.N.” Practice Location

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