Individual
JUSTIN GOUCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1100 N COLLEGE AVE, FAYETTEVILLE, AR 72703-1944
(479) 443-4301
Mailing address
9 SELLAND LN, BELLA VISTA, AR 72715-5568
(870) 225-6219
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
216579
AR
363LG0600X
Gerontology Nurse Practitioner
216579
AR
363LP2300X
Primary Care Nurse Practitioner
Primary
216579
AR
Other
Enumeration date
10/12/2021
Last updated
04/27/2022
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