Individual
CASSIDY WIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, ACNP-AG, FNP
Contact information
Practice address
9500 KANIS RD STE 410, LITTLE ROCK, AR 72205-6377
(501) 202-1500
Mailing address
434 STONERIDGE RD, AUSTIN, AR 72007-8052
(501) 744-8262
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A001940
AR
363LA2100X
Acute Care Nurse Practitioner
GAA-NP000101
GA
363LF0000X
Family Nurse Practitioner
A001940
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5A302
MCRA
AR
01
—
P00385212
MCRA RR
AR
Enumeration date
11/03/2006
Last updated
08/21/2021
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