Provider Demographics
NPI:1497446975
Name:ADAMS, GREGORY FLINN (APRN-CNP-PMHNP)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:FLINN
Last Name:ADAMS
Suffix:
Gender:M
Credentials:APRN-CNP-PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:LONOKE
Mailing Address - State:AR
Mailing Address - Zip Code:72086-3506
Mailing Address - Country:US
Mailing Address - Phone:501-266-0363
Mailing Address - Fax:
Practice Address - Street 1:603 S CENTER ST
Practice Address - Street 2:
Practice Address - City:LONOKE
Practice Address - State:AR
Practice Address - Zip Code:72086-3506
Practice Address - Country:US
Practice Address - Phone:501-266-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR224013363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health