Doctor Name: | DURINDA PENA |
NPI Number: | 1003841883 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | A.P.N. |
License Number: | A02908 APN |
Business Practice Address: | 3232 N North Hills Blvd. Fayetteville, AR - 727034005 |
Business Phone Number: | 4795871700 |
Business Fax Number: | 4795871366 |
Mailing Address: | 3501 Sw Town Vu, BENTONVILLE |
State: | AR |
Postal Code: | 72712 |
Phone Number: | 4795871700 |
Fax Number: | 4795871366 |
NPI Enumeration Date: | 07/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A02908 APN |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |