Individual provider Active NPI

Brandelein Marie Stefonek

  • Nurse Practitioner
  • Fayetteville, AR
National Provider Identifier
1902749880
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
236599 Issued in AR
Practice address
3215 N Northhills Blvd
Fayetteville, AR 72703-4424
Phone
(479) 463-1000
NPI assigned
Apr 14, 2026
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 236599 AR Primary

Addresses

Primary practice location

3215 N Northhills Blvd
Fayetteville, AR 72703-4424

Mailing address

308 Westfield St
Gravette, AR 72736-9371
Phone (316) 249-1625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

114 E Sunbridge Dr
Fayetteville, AR 72703-2830

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
236599ARMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1776124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1902749880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 WESTFIELD ST",
            "city": "GRAVETTE",
            "state": "AR",
            "postal_code": "727369371",
            "telephone_number": "316-249-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N NORTHHILLS BLVD",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034424",
            "telephone_number": "479-463-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEFONEK",
        "first_name": "BRANDELEIN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-14",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "236599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.