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Individual

MRS. TREVA M CHURCHWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN WON

Contact information

Practice address
1 MEDICAL PARK DR, BENTON, AR 72015-3353
(501) 776-6000
Mailing address
2326 HORSESHOE LOOP, LITTLE ROCK, AR 72206-9020
(501) 580-1450
(501) 500-5897

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R85437
AR
163WH0200X
Home Health Registered Nurse
R85437
AR
163WH1000X
Hospice Registered Nurse
R85437
AR
163WW0000X
Wound Care Registered Nurse
Primary
R85437
AR
163WX1500X
Ostomy Care Registered Nurse
R85437
AR

Other

Enumeration date
10/31/2022
Last updated
10/31/2022
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