Provider Demographics
NPI:1407628365
Name:RS RENEWAL LLC
Entity type:Organization
Organization Name:RS RENEWAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MSN APRN FNP-C
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:479-616-0690
Mailing Address - Street 1:602 ARCADIA DR
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-3534
Mailing Address - Country:US
Mailing Address - Phone:479-616-0690
Mailing Address - Fax:479-553-1969
Practice Address - Street 1:2900 MEDICAL CENTER PKWY STE 140
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-3212
Practice Address - Country:US
Practice Address - Phone:479-616-0690
Practice Address - Fax:479-553-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty