Provider Demographics
NPI:1427947738
Name:NOBULLE PRIMARY CARE LLC
Entity type:Organization
Organization Name:NOBULLE PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:COONFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-803-2188
Mailing Address - Street 1:1000 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:AR
Mailing Address - Zip Code:71730-3711
Mailing Address - Country:US
Mailing Address - Phone:870-881-8008
Mailing Address - Fax:870-862-7374
Practice Address - Street 1:1000 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-3711
Practice Address - Country:US
Practice Address - Phone:870-881-8008
Practice Address - Fax:870-862-7374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty