MEDICARE: MR. BILLY H NOEL 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
1	163WG0000X	General Practice Registered Nurse	A01824	AR

General Provider Information

NPI Number	:	1790716314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BILLY H NOEL APN

Provider Business Mailing Address
First Line	:	9207 HIGHWAY 71 S STE 9
Second Line	:
City	:	FORT SMITH
State	:	AR
Zip	:	72916-9389
Country	:	US
Telephone Number	:	479-668-4778
Fax Number	:	479-675-1391

Provider Business Practice Location Address
First Line	:	9207HWY 71
Second Line	:	SUITE 8&9
City	:	FORT SMITH
State	:	AR
Zip	:	72916-4683
Country	:	US
Telephone Number	:	479-668-4778
Fax Number	:	479-675-1391

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/21/2023

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