Provider Demographics
NPI:1851614648
Name:NULL, GINA DANLEY (APN, MSN, ANP-BC,OCN)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:DANLEY
Last Name:NULL
Suffix:
Gender:F
Credentials:APN, MSN, ANP-BC,OCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 ROGERS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-4022
Mailing Address - Country:US
Mailing Address - Phone:479-314-7490
Mailing Address - Fax:479-314-7494
Practice Address - Street 1:7001 ROGERS AVE STE 200
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-4022
Practice Address - Country:US
Practice Address - Phone:479-314-7490
Practice Address - Fax:479-314-7494
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03331363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health