Matlock, Donna

Matlock, Donna is an individual health care provider with primary practice located at 2012 S Promenade Blvd , Rogers AR 72758. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Matlock, Donna can be contacted via phone (479) 616-1485.

Contact Information

Primary practice address
2012 S Promenade Blvd Rogers AR 72758
Phone: (479) 616-1485
Fax: (479) 239-0536
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AO1582 Arkansas

Profile Details

NPI number 1295780690
LBN Legal business name Matlock, Donna
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Apr 11th, 2019 - 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 1295780690 NPPES
Missouri MEDICAID 426270807
Missouri MEDICAID 148362758
Missouri Other P00378001

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