Annette Bacon, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R074049 Issued in AR

Practice address

2740 College Ave
Conway, AR 72034-6141

Phone

(501) 329-5459

Fax

(501) 327-1738

NPI assigned

Oct 31, 2012

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1942554845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346141",
            "telephone_number": "501-329-5459",
            "fax_number": "501-327-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346141",
            "telephone_number": "501-329-5459",
            "fax_number": "501-327-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "ANNETTE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AR",
            "license": "R074049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakia Lynn Aytch, LCSW
• Jessica Aytes, RECOVERY ASSISTANT
• B a Scroggins, Inc.
• B. Brooks Lawrence, M.D., P.a.
• Haley Loren Bachusz
• Mallory Bagwell, DO
• Allison Bailey, MS CCC-SLP
• Jamie Bailey, OTRL
• Payton Bailey, SLP
• Sydney Laine Bailey, M.S. CCC-SLP

• All providers in Conway, AR
• Registered Nurse in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.