Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeast Rehab LLC

Organization Gerontology Nurse Practitioner · NPI 1295276970

Southeast Rehab LLC is a Gerontology Nurse Practitioner in Lake Village, Arkansas. Registered with an NPI since 2017.

In the registry since
2017
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

903 Borgognoni Dr
Lake Village, AR 71653-1623
Phone: (318) 665-9950
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X

Record details

NPI number1295276970
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cathy Waldrop — Administrator · (318) 665-9950
Other names Southeast Part B Practice; Southeast Part B Practice
NPI enumeratedMarch 15, 2017
Last updated in NPPESJune 28, 2019
Mailing address903 Borgognoni Dr, Lake Village, AR 71653-1623