Individual
MR. GARY WASHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
300 S SHACKLEFORD RD, LITTLE ROCK, AR 72211-5725
(501) 918-0589
Mailing address
3 ARNOLD PALMER DR, MAUMELLE, AR 72113-6401
(501) 351-3299
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A006024
AR
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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