Individual
KELLIE JEAN WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1701 W CLARK RD, CLARKSVILLE, AR 72830-3915
(479) 774-9290
Mailing address
1701 W CLARK RD, CLARKSVILLE, AR 72830-3915
(479) 774-9290
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
120805
AR
Other
Enumeration date
07/28/2026
Last updated
07/28/2026
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