Provider Demographics
NPI:1366088775
Name:GARNER, PENNY LYNN (APRN)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:LYNN
Last Name:GARNER
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 1:724 N SPRING ST STE A
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-2913
Mailing Address - Country:US
Mailing Address - Phone:870-741-2500
Mailing Address - Fax:870-741-7618
Practice Address - Street 1:724 N SPRING ST STE A
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:870-741-7618
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR122552363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner