Provider Demographics
NPI:1750877528
Name:KASPAR, CALEB (APRN)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:KASPAR
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2911
Mailing Address - Country:US
Mailing Address - Phone:870-741-2500
Mailing Address - Fax:870-414-4789
Practice Address - Street 1:724 N SPRING ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2913
Practice Address - Country:US
Practice Address - Phone:870-741-2500
Practice Address - Fax:870-414-4789
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily