Provider Demographics
NPI:1053778266
Name:WOMEN'S HEALTH ASSOCIATES OF NWA, PLLC
Entity type:Organization
Organization Name:WOMEN'S HEALTH ASSOCIATES OF NWA, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-876-8111
Mailing Address - Street 1:500 SE PLAZA AVE
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3104
Mailing Address - Country:US
Mailing Address - Phone:479-876-8111
Mailing Address - Fax:479-876-8110
Practice Address - Street 1:500 SE PLAZA AVE
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712
Practice Address - Country:US
Practice Address - Phone:479-876-8111
Practice Address - Fax:479-876-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7546207V00000X
ARE-3417207V00000X
ARE-6081207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty