Provider Demographics
NPI:1740869007
Name:VOCQUE, TABATHA GAIL (APRN)
Entity type:Individual
Prefix:
First Name:TABATHA
Middle Name:GAIL
Last Name:VOCQUE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18614 PHILIS DR
Mailing Address - Street 2:
Mailing Address - City:HENSLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72065-9781
Mailing Address - Country:US
Mailing Address - Phone:501-475-8021
Mailing Address - Fax:
Practice Address - Street 1:24005 ARCH STREET PIKE STE 16
Practice Address - Street 2:
Practice Address - City:HENSLEY
Practice Address - State:AR
Practice Address - Zip Code:72065-5010
Practice Address - Country:US
Practice Address - Phone:501-475-8021
Practice Address - Fax:866-485-0549
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215157207Q00000X, 363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner