Individual
GRETCHEN LAUREL GOODNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
403 MORROW ST N STE D, MENA, AR 71953-4324
(479) 437-6080
(479) 437-6079
Mailing address
403 MORROW ST N STE D, MENA, AR 71953-4324
(479) 437-6080
(479) 437-6079
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003488
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195568758
—
AR
01
—
2I7543
MEDICARE
AR
Enumeration date
01/31/2011
Last updated
03/30/2023
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