Provider Demographics
NPI:1639327679
Name:ZIRBEL, LARA CHRISTENA (APN)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:CHRISTENA
Last Name:ZIRBEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:CHRISTENA
Other - Last Name:GIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:505 E MATTHEWS
Mailing Address - Street 2:STE 301
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401
Mailing Address - Country:US
Mailing Address - Phone:870-934-1099
Mailing Address - Fax:870-935-1754
Practice Address - Street 1:505 E MATTHEWS AVE
Practice Address - Street 2:SUITE #301
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3144
Practice Address - Country:US
Practice Address - Phone:870-934-1099
Practice Address - Fax:870-935-1754
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03160 ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARA03160ANPOtherADVANCED PRACTICE NURSE