Basic Information
Provider Information
NPI: 1376869065
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BINGLEY
FirstName: DONNA
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4702 W COMMERCIAL DR
Address2:  
City: NORTH LITTLE ROCK
State: AR
PostalCode: 721167068
CountryCode: US
TelephoneNumber: 5018125545
FaxNumber:  
Practice Location
Address1: 4702 W COMMERCIAL DR
Address2:  
City: NORTH LITTLE ROCK
State: AR
PostalCode: 721167068
CountryCode: US
TelephoneNumber: 5018125545
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/20/2010
LastUpdateDate: 04/20/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WP0808XR39930ARY Nursing Service ProvidersRegistered NursePsych/Mental Health

No ID Information.


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