Provider Demographics
NPI:1679006969
Name:PIATKOWSKI, CAROL ANN (APRN)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:PIATKOWSKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3493 BELLA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-5740
Mailing Address - Country:US
Mailing Address - Phone:479-265-3712
Mailing Address - Fax:479-265-3713
Practice Address - Street 1:3493 BELLA VISTA WAY
Practice Address - Street 2:
Practice Address - City:BELLA VISTA
Practice Address - State:AR
Practice Address - Zip Code:72714-5740
Practice Address - Country:US
Practice Address - Phone:479-265-3712
Practice Address - Fax:479-265-3713
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily