Gammon, Wendy Wynette

Gammon, Wendy Wynette is an individual health care provider with primary practice located at 1305 Arkansas Blvd Ste 104 , Texarkana AR 71854-1691. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gammon, Wendy Wynette can be contacted via phone (870) 648-1305.

Contact Information

Primary practice address
1305 Arkansas Blvd Ste 104 Texarkana AR 71854-1691
Phone: (870) 648-1305
Fax: (870) 648-1306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X A005928 Arkansas
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X AP128853 Texas

Profile Details

NPI number 1669848156
LBN Legal business name Gammon, Wendy Wynette
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2015
Last updated Sep 6th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669848156 NPPES
Arkansas MEDICAID 225050758

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