MARIE CHANTALE CROSSE


Address: 801 Viney Grove Rd, Prairie Grove, AR 72753-2623
Phone: 4798468100

MARIE CHANTALE CROSSE (NPI# 1205846813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1205846813
Entity Type Individual
Full Name MARIE CHANTALE CROSSE
Other Name MARIE CHANTAL SUMLIN
Credential APRN
Practice Address 801 Viney Grove Rd
Prairie Grove
AR 72753-2623
Mailing Address 614 E Emma Ave Ste 300
Springdale
AR 72764-4469
Practice Telephone 4798468100
Practice Fax Number 4794006024
Mailing Telephone 4797517417
Mailing Fax Number 4797512878
Enumeration Date 2006-08-08
Last Update Date 2014-06-02
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LC1500X Nurse Practitioner
Specialization: Community Health
A01830ANP AR Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
AR 155918758 05

Office Location

Street Address 801 VINEY GROVE RD
City PRAIRIE GROVE
State AR
Zip Code 72753-2623

Providers in the same location

NPI Name Taxonomy Address Enumeration
1518389089 St. Francis House Nwa, Inc. Clinic/Center 801 Viney Grove Rd, Prairie Grove, AR 72753-2623 2014-01-17
1083879167 Carrie A Nickles Counselor 801 Viney Grove Rd, Prairie Grove, AR 72753-2623 2008-07-28

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1710465190 Arcare Clinic/Center 3150 E. Heritage Parkway, Farmington, AR 72753 2018-07-30
1982821468 Deborah Paas Blackburn Speech-Language Pathologist 15322 Goose Creek Road, Prairie Grove, AR 72753 2007-04-19
1083742928 Brad Green Dentist 401 E Buchanan, Box 288, Prairie Grove, AR 72753 2007-03-01
1649332511 Sterling Drug Company Pharmacy 125 E. Buchanan Street, Prairie Grove, AR 72753 2006-12-15
1811911100 Andrew Thomas Bain Dentist 128 N Mock St, Prairie Grove, AR 72753 2006-07-27
1457548935 Brad H Green Dds Pa Dentist 401 E Buchanan, Prairie Grove, AR 72753 2007-09-28
1376572800 Ron D Lee Family Medicine 775 E Douglas St, Prairie Grove, AR 72753 2006-06-30
1376589754 Christian G Blankers Family Medicine 775 E Douglas St, Prairie Grove, AR 72753 2006-06-22
1801350137 Kacee Bodiford Nurse Practitioner 3150 E. Heritage Pwy, Prairie Grove, AR 72753-0000 2019-01-31
1164819330 Tracy Houston Specialist/Technologist 500 Cole Dr, Prairie Grove, AR 72753-2509 2015-04-24
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Taxonomy Information

Taxonomy Code 363LC1500X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Community Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1174637896 Brenda Fowler Nurse Practitioner 604 S Pecan St, Dermott, AR 71638-2228 2006-08-19
1720242241 Latarsha A Bryant Nurse Practitioner 215 E Bond Ave, West Memphis, AR 72301-3550 2008-07-14

Competitor

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City PRAIRIE GROVE
Zip Code 72753

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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