Braziel, Diana Kay

Braziel, Diana Kay is an individual health care provider with primary practice located at 3400 Se Macy Road Suite 18, Bentonville AR 72712. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Allopathic & Osteopathic Physicians / Urology. Allopathic & Osteopathic Physicians / Urology is her primary health care specialty. Braziel, Diana Kay can be contacted via phone (479) 268-6800.

Contact Information

Primary practice address
3400 Se Macy Road Suite 18 Bentonville AR 72712
Phone: (479) 268-6800
Fax: (479) 268-6802
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X P-T0807 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA-342 Arkansas
Allopathic & Osteopathic Physicians / Urology 208800000X PA-342 Arkansas

Profile Details

NPI number 1225297260
LBN Legal business name Braziel, Diana Kay
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2008
Last updated Jun 9th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225297260 NPPES
Arkansas Other PA-342 ARKANSAS STATE MEDICAL BOARD LICENSE NUMBER
Arkansas Other P-T0807 ARKANSAS STATE MEDICAL BOARD LICENSE NUMBER
Arkansas Other 1081767 ARKANSAS STATE MEDICAL BOARD LICENSE NUMBER

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