Individual
MRS. KENDYL WASHBURN MIEDEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9601 BAPTIST HEALTH DR STE 860, LITTLE ROCK, AR 72205-6375
(501) 975-7456
(501) 975-1822
Mailing address
9601 BAPTIST HEALTH DR STE 860, LITTLE ROCK, AR 72205-6375
(501) 975-7455
(501) 975-3631
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-426
AR
363AM0700X
Medical Physician Assistant
PA-426
AR
363AS0400X
Surgical Physician Assistant
PA-426
AR
Other
Enumeration date
02/04/2011
Last updated
10/19/2018
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