Individual
WENDY WYNETTE GAMMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1305 ARKANSAS BLVD STE 104, TEXARKANA, AR 71854-1691
(870) 648-1305
(870) 648-1306
Mailing address
PO BOX 295, LOCKESBURG, AR 71846-0295
(870) 289-5865
(870) 289-4594
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005928
AR
363LF0000X
Family Nurse Practitioner
AP128853
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225050758
—
AR
Enumeration date
08/19/2015
Last updated
09/06/2021
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