| Brandy Lee Vines, | |
|
2103 Slack St, Pea Ridge, AR 72751-4005 | |
| (765) 479-1980 | |
| Not Available |
| Full Name | Brandy Lee Vines |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 2 Years |
| Location | 2103 Slack St, Pea Ridge, Arkansas |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306602701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 227730 (Arkansas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Washington Regional Medical Center | Fayetteville, AR | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Washington Regional Medical System | 8820995434 | 227 |
| Entity Name | Washington Regional Medical System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306801485 PECOS PAC ID: 8820995434 Enrollment ID: O20051208000082 |
| Entity Name | Pea Ridge Urgent Care Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558140749 PECOS PAC ID: 1456796986 Enrollment ID: O20240223003115 |
| Mailing Address | Practice Location Address |
|---|---|
| Brandy Lee Vines, 2103 Slack St, Pea Ridge, AR 72751-4005 Ph: (479) 756-1980 | Brandy Lee Vines, 2103 Slack St, Pea Ridge, AR 72751-4005 Ph: (765) 479-1980 |
Mrs. Cyrece Dawn Engelberger, APRN, IBCLC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Carr St, Pea Ridge, AR 72751 Phone: 479-488-6415 | |
Georgia Mulkerins, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 2103 Slack St, Pea Ridge, AR 72751 Phone: 479-765-1980 Fax: 479-765-1982 |