Basic Information
| Provider Information | |||||||||
| NPI: | 1326468455 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DARBY | ||||||||
| FirstName: | GAIL | ||||||||
| MiddleName: | HAYES | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CNP- FNP-BC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | BEARDEN | ||||||||
| OtherFirstName: | GAIL | ||||||||
| OtherMiddleName: | HAYES | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | CNP- FNP-BC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2530 WEST BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705814318 | ||||||||
| FaxNumber: | 8702705135 | ||||||||
| Practice Location | |||||||||
| Address1: | 2530 WEST BROADWAY AVE | ||||||||
| Address2: | |||||||||
| City: | FORREST CITY | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8705814318 | ||||||||
| FaxNumber: | 8702705135 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2014 | ||||||||
| LastUpdateDate: | 08/05/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | A004038 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | R84749 | AR | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.