Provider Demographics
NPI:1457716029
Name:BARBEE-LUMPKIN, CHASTA MANDY (CNP)
Entity type:Individual
Prefix:MRS
First Name:CHASTA
Middle Name:MANDY
Last Name:BARBEE-LUMPKIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 TIMBER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DRASCO
Mailing Address - State:AR
Mailing Address - Zip Code:72530-9414
Mailing Address - Country:US
Mailing Address - Phone:501-628-1096
Mailing Address - Fax:
Practice Address - Street 1:609 SW 8TH ST FL 6
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7886
Practice Address - Country:US
Practice Address - Phone:337-991-9276
Practice Address - Fax:337-943-0846
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004563363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology