Provider Demographics
NPI:1093314973
Name:GARNER, ALISON REBECCA (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:REBECCA
Last Name:GARNER
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 GILLIS DR
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-4773
Mailing Address - Country:US
Mailing Address - Phone:501-844-6603
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS WAY # 512-2
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-3500
Practice Address - Country:US
Practice Address - Phone:501-364-3686
Practice Address - Fax:501-364-5339
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR123916363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics