Provider Demographics
NPI:1386089712
Name:GUNTORIUS, SARAH ANN (APRN-CNP)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ANN
Last Name:GUNTORIUS
Suffix:
Gender:F
Credentials:APRN-CNP
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Mailing Address - Street 1:1 CHILDRENS WAY # 844
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72202-3500
Mailing Address - Country:US
Mailing Address - Phone:501-364-2090
Mailing Address - Fax:501-364-3929
Practice Address - Street 1:2601 GENE GEORGE BLVD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0845
Practice Address - Country:US
Practice Address - Phone:479-725-6977
Practice Address - Fax:479-725-6577
Is Sole Proprietor?:No
Enumeration Date:2013-04-29
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013006662363LP0200X
ARA004356363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR213189758Medicaid