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Southeast Rehab Llc
Adult Health Nurse Practitioner in Lake Village, Arkansas
NPI 1942658729

Southeast Rehab Llc is an Adult Health Nurse Practitioner based in Lake Village, AR and is specialized in Adult Health. Southeast Rehab Llc practices in Lake Village, AR. The NPI Number for Southeast Rehab Llc is 1942658729 and holds a License No. (Arkansas).

The current practice location address for Southeast Rehab Llc is 903 Borgognoni Dr, Lake Village, AR and can be reached out via phone at 870-265-4333 and via fax at 318-665-0379.

Location: 903 Borgognoni Dr, Lake Village, AR, 71653-1623
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1942658729
Provider Name
Southeast Rehab Llc
Credential
Provider Entity Type
Organization
Address
903 Borgognoni Dr, Lake Village, AR, 71653-1623
Phone Number
870-265-4333
Fax Number
318-665-0379
Provider Enumeration Date
06/02/2016
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
903 Borgognoni Dr
City
Lake Village
State
Arkansas
Zip
71653-1623
Phone Number
870-265-4333
Fax Number
318-665-0379
person
Provider Business Mailing Address Details
Address
903 Borgognoni Dr
City
Lake Village
State
Arkansas
Zip
71653-1623
Phone Number
870-265-4333
Fax Number
318-665-0379
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
Adult Medicine
Taxonomy
207QA0505X
License No.
()
Definition
Definition to come.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
()
Definition
Definition to come...
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