Provider Demographics
NPI:1871554410
Name:GARNER, SETH (APRN)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:GARNER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-0698
Mailing Address - Country:US
Mailing Address - Phone:479-571-2273
Mailing Address - Fax:479-571-2226
Practice Address - Street 1:2111 S OLD MISSOURI RD STE E
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72764-8748
Practice Address - Country:US
Practice Address - Phone:479-571-2273
Practice Address - Fax:479-571-2226
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1554111N00000X
ARA004000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR731582026OtherHUMANA
AR731582026OtherBLUE CROSS BLUE SHIELD
AR731582026OtherCIGNA
AR731582026OtherAETNA
AR731582026OtherHUMANA
AR5U848Medicare PIN