Bonnie Anderson, APRN

Individual provider Active NPI Family Nurse Practitioner · Conway, AR

NPI 1942811047 · NPPES record last updated Oct 7, 2021

Key facts

NPI
1942811047
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
123592 (AR)
Practice address
2710 College Ave
Conway, AR 72034-6141
Phone
(501) 329-1800
Fax
(501) 329-2507
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
123592ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Pediatrics of Conway, PA Past
since Aug 23, 2020
Accepting new patients
Conway Regional Medical Center Inc Past
since Aug 23, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 123592 AR Yes

Addresses

Primary practice location

2710 College Ave
Conway, AR 72034-6141

Mailing address

PO Box 1210
Conway, AR 72033-1210
Phone (501) 329-1800

Other providers in Conway, AR

All providers in Conway, AR · Family Nurse Practitioner in Arkansas

Sources for this page

Verify at the official NPI Registry.