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NPI Code Detail

MEDICARE: MRS. PAULA JOANN BROSNAN APN

MEDICARE: MRS. PAULA JOANN BROSNAN APN
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
1363LA2200XAdult Health Nurse PractitionerA03703AR

General Provider Information

NPI Number : 1578818621
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PAULA JOANN BROSNAN APN
Provider Business Mailing Address
First Line : 8922 HOUSTON ST
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-5232
Country : US
Telephone Number : 479-459-2725
Fax Number :
Provider Business Practice Location Address
First Line : 7001 ROGERS AVE STE 200
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4022
Country : US
Telephone Number : 479-314-4620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2012
Last Update Date : 07/16/2012

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