Provider Demographics
NPI:1326549783
Name:NORTHWEST ARKANSAS SENIOR CARE SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:NORTHWEST ARKANSAS SENIOR CARE SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:OXFORD
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:479-445-3469
Mailing Address - Street 1:2629 N SIERRA AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3370
Mailing Address - Country:US
Mailing Address - Phone:479-445-3469
Mailing Address - Fax:877-693-6271
Practice Address - Street 1:2629 N SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3370
Practice Address - Country:US
Practice Address - Phone:479-445-3469
Practice Address - Fax:877-693-6271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-21
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC5210207Q00000X
ARA004438363LP2300X
ARS02236CNS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty