Elizabeth L Banda Aprn NP-C LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A004191 Issued in AR

Legal business name

ELIZABETH L BANDA APRN NP-C LLC

Practice address

920 S Highway 45
Bonanza, AR 72916-3420

Phone

(479) 255-6150

NPI assigned

Apr 6, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Elizabeth L Banda, APRN NP-C

Title

Sole Member

Phone

(918) 721-3955

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1459900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459900800000",
    "number": "1972967883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 TEAKWOOD DR",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749532244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S HIGHWAY 45",
            "city": "BONANZA",
            "state": "AR",
            "postal_code": "729163420",
            "telephone_number": "479-255-6150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH L BANDA APRN NP-C LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-06",
        "last_updated": "2016-04-06",
        "status": "A",
        "authorized_official_last_name": "BANDA",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "918-721-3955",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A004191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200597420A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katie Elizabeth Cormier McBroom, PHARMD
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• River Valley Primary Care Services
• River Valley Primary Care Services
• Brittney Beland Schmidt, DNP, NP-C

• All providers in Bonanza, AR
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2016; 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.