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NPI Code Detail

MEDICARE: ANDREW GAUSE QBHP-D

MEDICARE: ANDREW GAUSE QBHP-D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1750219580
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW GAUSE QBHP-D
Provider Business Mailing Address
First Line : 1310 W MAIN ST STE 201
Second Line :
City : RUSSELLVILLE
State : AR
Zip : 72801-2803
Country : US
Telephone Number : 479-968-2001
Fax Number :
Provider Business Practice Location Address
First Line : 1 LILE CT STE 200
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72205-6240
Country : US
Telephone Number : 501-663-1837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ ANDREW GAUSE QBHP-D” Practice Location

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