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Individual

KELLY L MADIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 636-0200
(479) 986-3448
Mailing address
2710 S RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 636-0200
(479) 986-3448

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60910189
WA
363LA2100X
Acute Care Nurse Practitioner
AP60910189
WA
363LG0600X
Gerontology Nurse Practitioner
Primary
A004821
AR
363LG0600X
Gerontology Nurse Practitioner
AP60910189
WA

Other

Enumeration date
04/06/2016
Last updated
02/13/2023
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