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NPI Code Detail

MEDICARE: MADELINE ROSE PACHECO

MEDICARE:   MADELINE ROSE PACHECO
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
1163WC0200XCritical Care Medicine Registered Nurse213005AR

General Provider Information

NPI Number : 1578497228
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE ROSE PACHECO
Provider Business Mailing Address
First Line : 701 SOUTH ST
Second Line :
City : MOUNTAIN HOME
State : AR
Zip : 72653-4452
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7301 ROGERS AVE
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4100
Country : US
Telephone Number : 479-314-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2026
Last Update Date : 06/09/2026

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Directions to “ MADELINE ROSE PACHECO ” Practice Location

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