MARIE CHANTALE CROSSE (NPI# 1205846813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205846813 |
Entity Type | Individual |
Full Name | MARIE CHANTALE CROSSE |
Other Name | MARIE CHANTAL SUMLIN |
Credential | APRN |
Practice Address |
801 Viney Grove Rd Prairie Grove AR 72753-2623 |
Mailing Address |
614 E Emma Ave Ste 300 Springdale AR 72764-4469 |
Practice Telephone | 4798468100 |
Practice Fax Number | 4794006024 |
Mailing Telephone | 4797517417 |
Mailing Fax Number | 4797512878 |
Enumeration Date | 2006-08-08 |
Last Update Date | 2014-06-02 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LC1500X |
Nurse Practitioner Specialization: Community Health |
A01830ANP | AR | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | 155918758 | 05 |
Street Address |
801 VINEY GROVE RD |
City | PRAIRIE GROVE |
State | AR |
Zip Code | 72753-2623 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518389089 | St. Francis House Nwa, Inc. | Clinic/Center | 801 Viney Grove Rd, Prairie Grove, AR 72753-2623 | 2014-01-17 |
1083879167 | Carrie A Nickles | Counselor | 801 Viney Grove Rd, Prairie Grove, AR 72753-2623 | 2008-07-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710465190 | Arcare | Clinic/Center | 3150 E. Heritage Parkway, Farmington, AR 72753 | 2018-07-30 |
1982821468 | Deborah Paas Blackburn | Speech-Language Pathologist | 15322 Goose Creek Road, Prairie Grove, AR 72753 | 2007-04-19 |
1083742928 | Brad Green | Dentist | 401 E Buchanan, Box 288, Prairie Grove, AR 72753 | 2007-03-01 |
1649332511 | Sterling Drug Company | Pharmacy | 125 E. Buchanan Street, Prairie Grove, AR 72753 | 2006-12-15 |
1811911100 | Andrew Thomas Bain | Dentist | 128 N Mock St, Prairie Grove, AR 72753 | 2006-07-27 |
1457548935 | Brad H Green Dds Pa | Dentist | 401 E Buchanan, Prairie Grove, AR 72753 | 2007-09-28 |
1376572800 | Ron D Lee | Family Medicine | 775 E Douglas St, Prairie Grove, AR 72753 | 2006-06-30 |
1376589754 | Christian G Blankers | Family Medicine | 775 E Douglas St, Prairie Grove, AR 72753 | 2006-06-22 |
1801350137 | Kacee Bodiford | Nurse Practitioner | 3150 E. Heritage Pwy, Prairie Grove, AR 72753-0000 | 2019-01-31 |
1164819330 | Tracy Houston | Specialist/Technologist | 500 Cole Dr, Prairie Grove, AR 72753-2509 | 2015-04-24 |
Find all providers in zip 72753 |
Taxonomy Code | 363LC1500X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Community Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174637896 | Brenda Fowler | Nurse Practitioner | 604 S Pecan St, Dermott, AR 71638-2228 | 2006-08-19 |
1720242241 | Latarsha A Bryant | Nurse Practitioner | 215 E Bond Ave, West Memphis, AR 72301-3550 | 2008-07-14 |
City | PRAIRIE GROVE |
Zip Code | 72753 |
Please comment or provide details below to improve the information on MARIE CHANTALE CROSSE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.