Mashala Monea Runyon
Individual provider Active NPI Home Health Aide · Magnolia, AR
NPI 1851635429 · NPPES record last updated Nov 20, 2012
Key facts
- NPI
- 1851635429
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 1407 Mallard
Magnolia, AR 71753-9710 - Phone
- (870) 562-1931
- NPI assigned
- Nov 20, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
1407 Mallard
Magnolia, AR 71753-9710
Mailing address
615 E McNeil
Magnolia, AR 71753-3061
Phone (870) 949-4544
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6047935001 | Medicaid | AR |
Other providers in Magnolia, AR
- Franklin Dowling Roberts
- Madison Ross
- Seketa S Ross
- James William Rotton
- James Kevin Rudder
- Candace Sanders
- Tammy Lynn Sanders
- Allison Grace Saunders
- Alyssa Scholl
- Brianna Schulz
All providers in Magnolia, AR · Home Health Aide in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.