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General NPI Number Information
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NPI Number | 1972260545
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Entity Type | Individual
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Provider Name | MICHAELA ERIN GARDNER APRN
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 1920 FALLS BLVD N
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City | WYNNE
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State | AR
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Zip | 72396-4027
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Country | US
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Telephone | 870-587-0800
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Fax | 870-587-0799
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Provider Business Mailing Address
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Address Line | 800 S CHURCH ST STE 400
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City | JONESBORO
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State | AR
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Zip | 72401-4112
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Country | US
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Telephone | 870-935-6012
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 217198
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License Number State | AR
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