Provider Demographics
NPI:1982248605
Name:SPECKING, GINGER R
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:R
Last Name:SPECKING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:573 GREENE 142 RD
Mailing Address - Street 2:
Mailing Address - City:LAFE
Mailing Address - State:AR
Mailing Address - Zip Code:72436
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:573 GREENE 142 RD
Practice Address - Street 2:
Practice Address - City:LAFE
Practice Address - State:AR
Practice Address - Zip Code:72436
Practice Address - Country:US
Practice Address - Phone:870-586-0527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider