Individual
WENDY A. GASTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
9755 W STATE HIGHWAY 22, RATCLIFF, AR 72951-9000
(479) 369-2091
(479) 369-4119
Mailing address
4003 MASSARD, FORT SMITH, AR 72903
(479) 226-3836
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A01804
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157718758
—
AR
01
—
771007858
ARKANSAS BREAST CARE
AR
Enumeration date
06/16/2006
Last updated
07/30/2020
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