Provider Demographics
NPI:1962630079
Name:PARHAM, REBECCA ANN (APN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:PARHAM
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 PLAFCAN RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:AR
Mailing Address - Zip Code:72024-9364
Mailing Address - Country:US
Mailing Address - Phone:870-672-1494
Mailing Address - Fax:
Practice Address - Street 1:1450 PLAFCAN RD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:AR
Practice Address - Zip Code:72024-9364
Practice Address - Country:US
Practice Address - Phone:870-672-1494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03230 ANP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology