Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | A01546 | AR |
N | 363LF0000X | Nurse Practitioner - Family Medicine | A01546ANP | AR |
NPI | 1043276439 |
---|---|
Provider Name | Ms. Rebecca L. Gartner |
First Address | Hot Springs, AR 71913-6475 |
Second Address | Hot Springs, AR 71913-6475 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 08/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
179169758 | (05) | AR |
A01546 | STATE LICENSE (01) | AR |
P61256 | (02) | |
P61256 | (02) | AR |