Provider Demographics
NPI:1821042300
Name:BURCHFIELD, DANA LYNNE (APN)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LYNNE
Last Name:BURCHFIELD
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12 E APPLEBY RD
Mailing Address - Street 2:CLINIC ADMINISTRATION
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3901
Mailing Address - Country:US
Mailing Address - Phone:479-463-1704
Mailing Address - Fax:479-463-7864
Practice Address - Street 1:3000 NW A ST
Practice Address - Street 2:WASHINGTON REGIONAL DIAGNOSTIC CLINIC
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3985
Practice Address - Country:US
Practice Address - Phone:479-268-3050
Practice Address - Fax:479-273-0050
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARA001803363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158940758Medicaid
AR5Y041Medicare PIN