Individual
KAYLA RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
655 DAVE WARD DR, CONWAY, AR 72034-7083
(501) 209-4040
Mailing address
655 DAVE WARD DR STE 101, CONWAY, AR 72034-7145
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R093505
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F12170822
AANP
TX
Enumeration date
01/29/2018
Last updated
04/01/2020
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