1639327679 NPI number — LARA CHRISTENA ZIRBEL APN

Table of content: GRANT GASE (NPI 1407437270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639327679 NPI number — LARA CHRISTENA ZIRBEL APN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZIRBEL
Provider First Name:
LARA
Provider Middle Name:
CHRISTENA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIL
Provider Other First Name:
LARA
Provider Other Middle Name:
CHRISTENA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639327679
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
505 E MATTHEWS AVE STE 301
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JONESBORO
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72401-3101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-207-7350
Provider Business Mailing Address Fax Number:
870-207-0575

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
505 E MATTHEWS AVE STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JONESBORO
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72401-3101
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-207-7350
Provider Business Practice Location Address Fax Number:
870-207-0575
Provider Enumeration Date:
09/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  A03160 ANP , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A03160ANP . This is a "ADVANCED PRACTICE NURSE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".




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