Provider Demographics
NPI:1275638728
Name:SMEDLEY, BERNA K (APN)
Entity Type:Individual
Prefix:
First Name:BERNA
Middle Name:K
Last Name:SMEDLEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 PONCE DE LEON DR
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71909-8121
Mailing Address - Country:US
Mailing Address - Phone:501-922-1700
Mailing Address - Fax:501-922-0826
Practice Address - Street 1:410 PONCE DE LEON DR
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-8121
Practice Address - Country:US
Practice Address - Phone:501-922-1700
Practice Address - Fax:501-922-0826
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01653363LF0000X
ARAO1653APN363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR167900758Medicaid
AR5T842Medicare PIN
AR167900758Medicaid