Doctor Name: | DEENA DAVON GARNER |
NPI Number: | 1013358522 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | A003913 |
Business Practice Address: | 2850 Twin Rivers Dr Arkadelphia, AR - 719234212 |
Business Phone Number: | 8702468036 |
Business Fax Number: | |
Mailing Address: | 2850 Twin Rivers Dr, ARKADELPHIA |
State: | AR |
Postal Code: | 719234212 |
Phone Number: | 8702468036 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2013 |
NPI Last Update Date: | 10/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | A003913 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |