Healthcare Provider Details

I. General information

NPI: 1124952650
Provider Name (Legal Business Name): KIMBERLY GARLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GO DEVIL DR
GURDON AR
71743-9102
US

IV. Provider business mailing address

264 CENTRAL RD
ARKADELPHIA AR
71923-7274
US

V. Phone/Fax

Practice location:
  • Phone: 870-260-6018
  • Fax:
Mailing address:
  • Phone: 870-260-6018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR106516
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: