| Organization Name: | NEA RELIANT HEALTH CARE PROFESSIONALS INC |
| NPI Number: | 1467829804 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VANESSA ANN ELLIS (CREDENTIALIST) |
| Mailing Address: | 9146 Highway 63 N Bono |
| State: | AR US |
| Postal Code: | 724168153 |
| Phone Number: | 8709309990 |
| Fax Number: | 8709309992 |
| NPI Enumeration Date: | 09/01/2015 |
| NPI Last Update Date: | 09/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | A003947 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |