Provider Demographics
NPI:1780348474
Name:GOUCHER, LINDSEY ANN (APRN)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:GOUCHER
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 1:9 SELLAND LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72715-5568
Mailing Address - Country:US
Mailing Address - Phone:501-514-0779
Mailing Address - Fax:
Practice Address - Street 1:3300 S MARKET ST STE 118
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-8127
Practice Address - Country:US
Practice Address - Phone:479-366-0850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR217887363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty