REBECCA BROADBENT (NPI# 1578183653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578183653 |
| Entity Type | Individual |
| Full Name | REBECCA BROADBENT |
| Credential | DO |
| Practice Address |
1601 W 40th Ave Ste 100 Pine Bluff AR 71603-6069 |
| Practice Telephone | 8705416000 |
| Practice Fax Number | 8705416010 |
| Mailing Telephone | 8705416000 |
| Mailing Fax Number | 8705416010 |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2020-04-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1601 W 40th Ave Ste 100, Pine Bluff, AR 716036069 | 8705416000 | 8705416010 |
| Street Address |
1601 W 40TH AVE STE 100 |
| City | PINE BLUFF |
| State | AR |
| Zip Code | 71603-6069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649700337 | Raquel M Rivera-cruz | Family Medicine | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2017-06-14 |
| 1104446103 | Tracey Lockhart | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1073133179 | Sree Chellappan | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1205456217 | Candace Wilson | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1316567415 | Tessa Cucurullo Herren | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1487217592 | Amilyn M Worlobah | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6319 | 2019-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700445038 | Hannah Carter | Dentist | 3801 S Olive St, Pine Bluff, AR 71603 | 2019-06-11 |
| 1821544628 | Nauman Yunus Md Pa | Internal Medicine | 1600 West 40th Ave, Jefferson Regional Medical Center, Pine Bluff, AR 71603 | 2016-08-31 |
| 1407278120 | Arkansas Cancer Clinic Pa | Radiology | 7200 South Hazel Street, Pine Bluff, AR 71603 | 2014-01-15 |
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1477992733 | David Larry Byrd | Pharmacist | 5 Longmeadow, Pine Bluff, AR 71603 | 2013-06-20 |
| 1437400371 | Thomas Jordan Harper | Pharmacist | 2809 South Camden Road, Pine Bluff, AR 71603 | 2012-10-01 |
| 1992080469 | C&d Disability.inc | Early Intervention Provider Agency | 4806 W 9th Street, Pine Bluff, AR 71603 | 2011-10-17 |
| 1457645863 | Clifton G Roaf & Marvin Q Caudle | Dentist | 1310 South Linden Street, Pine Bluff, AR 71603 | 2011-06-02 |
| 1932402682 | Mary Campbell | Licensed Practical Nurse | 2302 W. 28th, Suite A, Pine Bluff, AR 71603 | 2010-12-17 |
| 1245468925 | Evan N Newbolt | Ophthalmology | 3805 West 28th Ave, Pine Bluff, AR 71603 | 2009-07-01 |
| Find all providers in zip 71603 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730515396 | Sharon Yvette Webb | Student in an Organized Health Care Education/Training Program | 2318 Kyle Street, Pine Bluff, AR 71603 | 2013-09-16 |
| 1104446103 | Tracey Lockhart | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1073133179 | Sree Chellappan | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1205456217 | Candace Wilson | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1316567415 | Tessa Cucurullo Herren | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6069 | 2020-04-20 |
| 1487217592 | Amilyn M Worlobah | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 100, Pine Bluff, AR 71603-6319 | 2019-04-16 |
| 1770043044 | Riham M Wahba | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 1, Pine Bluff, AR 71603-6319 | 2019-03-22 |
| 1528528809 | Sania Sayani | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 1, Pine Bluff, AR 71603-6319 | 2019-03-22 |
| 1194285478 | Anum Rasheed | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 1, Pine Bluff, AR 71603-6319 | 2019-03-22 |
| 1962962241 | Ainny Shamim | Student in an Organized Health Care Education/Training Program | 1601 W 40th Ave Ste 1, Pine Bluff, AR 71603-6319 | 2019-03-22 |
| Find all providers in PINE BLUFF | ||||
| City | PINE BLUFF |
| Zip Code | 71603 |
Please comment or provide details below to improve the information on REBECCA BROADBENT.
| 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.