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Individual

MRS. BRANDI MARIE GUNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
(479) 636-4587
Mailing address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
(479) 636-4587

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0450492
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L045492
PASSE
AR
Enumeration date
06/19/2020
Last updated
06/19/2020
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