DOMINIQUE ANN ERTOLACCI (NPI# 1386291656) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386291656 |
| Entity Type | Individual |
| Full Name | DOMINIQUE ANN ERTOLACCI |
| Credential | NP |
| Practice Address |
609 W Maple Ave Springdale AR 72764-5335 |
| Practice Telephone | 4795531000 |
| Mailing Telephone | 3605608999 |
| Mailing Fax Number | 4795531000 |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-09-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 121999 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
609 W MAPLE AVE |
| City | SPRINGDALE |
| State | AR |
| Zip Code | 72764-5335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689676272 | Regency Hospital of Northwest Arkansas, LLC | Long Term Care Hospital | 609 W Maple Ave, 6th Floor, Springdale, AR 72764-5335 | 2005-08-12 |
| 1356957799 | Victoria Ashley Sollestre | Physician Assistant | 609 W Maple Ave, Springdale, AR 72764-5335 | 2020-09-21 |
| 1588279475 | Ashley Early | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5394 | 2020-09-09 |
| 1710504931 | Sandra Lee Moore | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5335 | 2020-07-03 |
| 1861055204 | Dustin J Franklin | Nurse Anesthetist, Certified Registered | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-04-22 |
| 1407419278 | Samuel Tanner Burks | Registered Nurse | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-04-17 |
| 1285199133 | Shelby Lane Harrison | Registered Nurse | 609 W Maple Ave, Springdale, AR 72764-5335 | 2019-02-05 |
| 1750865929 | Teqienna Dianne Randall | Nurse Practitioner | 609 W Maple Ave, Springdale, AR 72764-5335 | 2018-09-24 |
| 1588144182 | David R Massey Md Pllc | Psychiatry & Neurology | 609 W Maple Ave, Springdale, AR 72764-5335 | 2018-08-14 |
| 1619453495 | Jacquelyn Lange-halley Md Pllc | Psychiatry & Neurology | 609 W Maple Ave, Springdale, AR 72764 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851903884 | Conway County Community Service Inc. | Community/Behavioral Health | 616 E. Emma Avenue, Suite 244, Springdale, AR 72764 | 2020-08-20 |
| 1316592801 | Above and Beyond Pediatric Therapy, Inc | Speech-Language Pathologist | 2700 American St., Ste B, Springdale, AR 72764 | 2019-08-02 |
| 1053871061 | Specialized Hearing Instruments, Inc. | Audiologist-Hearing Aid Fitter | 958 S. West End St., Springdale, AR 72764 | 2019-03-25 |
| 1801385976 | Taylor Beauregard Kelamis | Nurse Practitioner | Mercy Clinic Family Medicine, 1110 W. Robinson Ave, Springdale, AR 72764 | 2018-05-04 |
| 1649726878 | Ember Estelle Lanuti Brown | Speech-Language Pathologist | 4209 Navajo Court, Springdale, AR 72764 | 2016-08-28 |
| 1568838241 | Elayna Wells | Speech-Language Pathologist | 900 S Powell Street, Springdale, AR 72764 | 2015-08-17 |
| 1184003261 | Okeyo Oghina | Nurse Practitioner | 609 West Maple Avenue, Northwest Health System, Springdale, AR 72764 | 2015-05-22 |
| 1235524869 | William M Rogers | Family Medicine | 513 N. Shiloh Street, Springdale, AR 72764 | 2015-03-31 |
| 1336498872 | Kelly Meeann Miller | Speech-Language Pathologist | 105 S Blair Street, Springdale, AR 72764 | 2012-08-30 |
| 1902183874 | Cristy Hoffman | Physical Therapy Assistant | 2837 American St Ste A, Springdale, AR 72764 | 2011-11-07 |
| Find all providers in zip 72764 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639640527 | Marathon Health, LLC | Nurse Practitioner | 3880 Willowood Ave, Springdale, AR 72762-2774 | 2018-12-17 |
| 1720514847 | Sasha Laine Kutz | Nurse Practitioner | 1678 Kensington Pl, Springdale, AR 72764-1159 | 2017-05-10 |
| 1558810937 | Sas-apn LLC | Nurse Practitioner | 5304 Bryant Pl, Springdale, AR 72764-2585 | 2016-09-27 |
| 1144604760 | Lorri Logan Cigalina | Nurse Practitioner | 4301 Greahouse Springs Rd, Springdale, AR 72762 | 2015-07-14 |
| 1598052250 | Leann W Metheny | Nurse Practitioner | 700 N 40th St Ste B, Springdale, AR 72762-0633 | 2011-07-01 |
| 1790765121 | Wendy Leigh Sisson | Nurse Practitioner | 6885 Harlan Ave, Springdale, AR 72762-4195 | 2006-01-20 |
| 1144836909 | Kasilynn Alese Shaddy | Nurse Practitioner | 3300 W Sunset Ave, Springdale, AR 72762-4950 | 2020-09-17 |
| 1831709518 | Metheny Family Care Clinic Corp | Nurse Practitioner | 700 N 40th St Ste B, Springdale, AR 72762-0633 | 2020-08-06 |
| 1750918660 | Lrae Urainuz Wintercorn | Nurse Practitioner | 4001 Wagon Wheel Rd, Springdale, AR 72762-0137 | 2020-03-23 |
| 1336705813 | Candra Nicole Ray | Nurse Practitioner | 813 Founders Park Dr E Ste 203, Springdale, AR 72762-6322 | 2019-05-10 |
| Find all providers in SPRINGDALE | ||||
| City | SPRINGDALE |
| Zip Code | 72764 |
Please comment or provide details below to improve the information on DOMINIQUE ANN ERTOLACCI.
| 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.