Individual
MS. STACY LEE KENNIGSEDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
5 SALOME ST, FORT SMITH, AR 72901-6546
(479) 414-4779
Mailing address
5 SALOME ST, FORT SMITH, AR 72901-6546
(479) 414-4779
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
R094022
AR
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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