Active NPI
Rose Mary Nichols, APRN FNP-C
- Family Nurse Practitioner
- Blytheville, AR
National Provider Identifier
1811547003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A006223
- Practice address
- 1400 N Division St
Blytheville, AR 72315-1438 - Phone
- (870) 776-1054
- NPI assigned
- Sep 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A006223 | AR | Primary |
Addresses
Primary practice location
1400 N Division St
Blytheville, AR 72315-1438
Mailing address
1110 W Walnut St
Blytheville, AR 72315-3256
Phone (870) 740-8612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A006223 | AR | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568851200000",
"number": "1811547003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1110 W WALNUT ST",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723153256",
"telephone_number": "870-740-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N DIVISION ST",
"city": "BLYTHEVILLE",
"state": "AR",
"postal_code": "723151438",
"telephone_number": "870-776-1054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICHOLS",
"first_name": "ROSE",
"middle_name": "MARY",
"credential": "APRN FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-19",
"last_updated": "2019-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A006223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blytheville, AR
- Kimberly Diane Nelson
- Nephrology Associates, PC
- Tiffany Marie Nettles
- New York Institute of Technology
- Tara Camille Newman-Carter, LCSW
- Christina L Nicklson, RN
- Brian S Niles, M.D.
- North Division Street Emergency Physicians
- Northeast Arkansas Community Mental Health Center Inc
- Northeast Arkansas Community Mental Health Center Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.