NPI 1255579124 · live from the CMS NPI Registry
Kimberly Ann Grundy, APN
Nurse Practitioner, Pediatrics in Little Rock, AR. National Provider Identifier 1255579124, active.
NPI record
| NPI | 1255579124 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 800 Marshall St # 512-3, Little Rock, AR 72202 |
| Practice phone | 501-364-1479 |
| Mailing address | 12a S Beryl Rd, Jacksonville, AR 72076 |
| Enumerated | January 29, 2009 |
| Last updated | January 29, 2009 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | A03184 (AR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.