Provider Demographics
NPI:1295563575
Name:GATLIFF, DEBORAH ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:GATLIFF
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 ARK 354
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9346
Mailing Address - Country:US
Mailing Address - Phone:870-371-4125
Mailing Address - Fax:
Practice Address - Street 1:10 PRISON CIR
Practice Address - Street 2:
Practice Address - City:CALICO ROCK
Practice Address - State:AR
Practice Address - Zip Code:72519-9054
Practice Address - Country:US
Practice Address - Phone:870-297-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR228411363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health