Individual
MRS. REBECCA WYNNE NOVACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9601 INTERSTATE 630, EXIT 7, LITTLE ROCK, AR 72205-7202
(501) 202-2093
(501) 202-6316
Mailing address
11001 EXECUTIVE CENTER DR, SUITE 200, LITTLE ROCK, AR 72211-4316
(501) 202-2093
(501) 202-6316
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
C002941
AR
390200000X
Student in an Organized Health Care Education/Training Program
R081455
AR
Other
Enumeration date
12/12/2012
Last updated
01/04/2013
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