Individual
HEATHER DENISE MCKINZIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
6209 W 12TH ST, LITTLE ROCK, AR 72204-1505
(501) 663-5221
(501) 663-6759
Mailing address
6209 W 12TH ST, LITTLE ROCK, AR 72204-1505
(501) 663-5221
(501) 663-6759
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A005480
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A005480
APN LICENSE
AR
Enumeration date
10/03/2018
Last updated
08/06/2021
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