Individual
KACIE LARAE FELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 WAGON WHEEL RD, SPRINGDALE, AR 72762-0137
(479) 725-3000
Mailing address
4001 WAGON WHEEL RD, SPRINGDALE, AR 72762-0137
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
120279
AR
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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