Provider Demographics
NPI:1598765208
Name:NEPOMUCENO, ARLENE URMAZA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:URMAZA
Last Name:NEPOMUCENO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E APPLEBY RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3928
Mailing Address - Country:US
Mailing Address - Phone:479-463-4444
Mailing Address - Fax:
Practice Address - Street 1:12 E APPLEBY RD STE 101
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-3928
Practice Address - Country:US
Practice Address - Phone:479-463-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4939207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR16459001Medicaid
NY114AN1Medicare ID - Type Unspecified
AR16459001Medicaid