Provider Demographics
NPI:1346841723
Name:HEARNE, GARBO WATSON (NP)
Entity Type:Individual
Prefix:MRS
First Name:GARBO
Middle Name:WATSON
Last Name:HEARNE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72206
Mailing Address - Country:US
Mailing Address - Phone:501-224-2800
Mailing Address - Fax:501-224-2829
Practice Address - Street 1:1001 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72206
Practice Address - Country:US
Practice Address - Phone:501-224-2800
Practice Address - Fax:501-224-2829
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP00561363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology