Individual
TAYLOR RENE' SIEROCUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
2708 S RIFE MEDICAL LN STE 220, ROGERS, AR 72758-1456
(479) 338-4400
(479) 338-4445
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 543-6979
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R093762
AR
163WC0200X
Critical Care Medicine Registered Nurse
12526976
AR
363LA2100X
Acute Care Nurse Practitioner
Primary
225030
AR
Other
Enumeration date
07/07/2023
Last updated
08/31/2023
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