Provider Demographics
NPI:1437484532
Name:PROFESSIONAL REGISTERED NURSES INC
Entity Type:Organization
Organization Name:PROFESSIONAL REGISTERED NURSES INC
Other - Org Name:PRN MEDICAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:479-785-9222
Mailing Address - Street 1:4500 ROGERS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3147
Mailing Address - Country:US
Mailing Address - Phone:479-785-9222
Mailing Address - Fax:479-785-1116
Practice Address - Street 1:4500 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3147
Practice Address - Country:US
Practice Address - Phone:479-785-9222
Practice Address - Fax:479-785-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR176196797Medicaid
AR164717757Medicaid
AR168712732Medicaid
AR175994765Medicaid