Renee Arlene Walls

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A01564ANP Issued in AR

Practice address

1100 Henderson St
Arkadelphia, AR 71999-5020

Phone

(870) 230-5102

Fax

(870) 230-5064

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Henderson State University

  • Family Medicine Physician
  • Arkadelphia, AR
  • NPI 1043968894
  NPD Authorized official
• Hempstead County Health Department

  • Public Health or Welfare Agency
  • Hope, AR
  • NPI 1518979483
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1790876753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 HENDERSON ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719990001",
            "telephone_number": "870-230-5102",
            "fax_number": "870-230-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HENDERSON ST",
            "city": "ARKADELPHIA",
            "state": "AR",
            "postal_code": "719995020",
            "telephone_number": "870-230-5102",
            "fax_number": "870-230-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLS",
        "first_name": "RENEE",
        "middle_name": "ARLENE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A01564ANP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• W.P.Malone Inc
• Wal-Mart Stores, Inc.
• Walgreen Co
• Walgreen Co.
• Kathleen Nicole Wallace, B.S.E.
• Walmart Inc.
• Misty Walters
• Treasure Walton
• Tina Ward
• Malik Ware

• Family Nurse Practitioner in Arkadelphia, AR
• Providers in Arkadelphia, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.