NPI 1083863609 · live from the CMS NPI Registry
Michele R Kilmer, PNP
Nurse Practitioner, Pediatrics in Springdale, AR. National Provider Identifier 1083863609, active.
NPI record
| NPI | 1083863609 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 5203 Willow Creek Dr, Springdale, AR 72762 |
| Practice phone | 479-251-8000 |
| Mailing address | 3794 Rock Springs St, Springdale, AR 72762 |
| Enumerated | September 18, 2008 |
| Last updated | August 31, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | 632703 (TX) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | A03324 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.