Individual provider · NPI-1

Garry Edward Allen, FNP

Nurse Practitioner, Family · Texarkana, AR

NPI number1861772634
StatusActive
Last updated in NPPESJan 31, 2022

Details

NPI
1861772634
Entity type
Individual (NPI-1)
Name
Mr. Garry Edward Allen
Credential
FNP
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 24, 2011
Certification date
Jan 31, 2022
Last updated
Jan 31, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family1692TXYes
363LF0000X Nurse Practitioner, Family217347AR

Practice location

433 Edgewood Dr
Texarkana, AR 71854-0249

Phone 870-653-5035

Mailing address

701 Arkansas Blvd
Texarkana, AR 71854-2105

Phone 870-772-5028

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